Akute Schwellung im Halsbereich nach iodhaltigem Kontrastmittel – der oft unerkannte Iodmumps anhand von drei Fallbeispielen

Zusammenfassung

Es werden drei Patientinnen vorgestellt, die zur Abklärung einer akuten Halsschwellung nach einer Untersuchung mit iodierten Kontrastmitteln zugewiesen wurden. Bei allen drei war ein akutes Angioödem vermutet worden, das allerdings nicht ausreichend auf Antihistaminika und Kortikosteroide ansprach. Es wurde schließlich ein sog. „Iodmumps“ oder Iod-assoziierte Sialoadenopathie diagnostiziert. Sonografisch und histologisch finden sich lediglich ein Ödem der Speicheldrüsen, hingegen keine Hinweise für eine ausgeprägte entzündliche Reaktion. Diese Komplikation ist nicht so selten und wird von Iod selbst ausgelöst, wie mit einer Provokation mit Iod-Kaliumiodid (Lugolʼscher Lösung) nachgewiesen werden konnte. Die pathophysiologisch ungeklärte Iod-assoziierte Sialoadenopathie wird somit als idiosynkratische Reaktion klassifiziert.

Abstract

Three female patients are presented who were referred for evaluation of acute neck swellings after examination with iodinated contrast media. Acute angioedema was suspected in all three but did not respond adequately to antihistamines and corticosteroids. The patients were eventually diagnosed with so-called iodine mumps or iodine-associated sialoadenopathy. Sonographically and histologically, there was only edema of the salivary glands, but no evidence of a pronounced inflammatory reaction. This complication is not uncommon and is triggered by iodine itself, as could be demonstrated by provocation with iodine potassium iodide (Lugol solution). The pathophysiologically unexplained iodine-associated sialoadenopathy is thus classified as an idiosyncratic reaction.

Publication History

Article published online:
22 February 2022

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