Abstract:these results show that non-therapeutic exposure to penicillin can cause severe symptoms and that in vitro and in vivo testing can help in the diagnosis of such cases.
“…A recent study of IgE to chlorhexidine measured by a prototype of the ImmunoCAP in patients with positive prick test results to chlorhexidine digluconate had a lower yield of positive IgE tests, but sera were taken an average of 29 months after the reaction. 14 A decline in the IgE antibody response to chlorhexidine has previously been measured in 1 patient, 8 and the same has been described for other allergens such as penicillin 15 and insect venom. 16 In this study, serial analyses for both IgE and HR in 1 patient showed an almost identical decline over time (Fig 5, A).…”
“…A recent study of IgE to chlorhexidine measured by a prototype of the ImmunoCAP in patients with positive prick test results to chlorhexidine digluconate had a lower yield of positive IgE tests, but sera were taken an average of 29 months after the reaction. 14 A decline in the IgE antibody response to chlorhexidine has previously been measured in 1 patient, 8 and the same has been described for other allergens such as penicillin 15 and insect venom. 16 In this study, serial analyses for both IgE and HR in 1 patient showed an almost identical decline over time (Fig 5, A).…”
“…Little evidence is available in the literature concerning this problem. Resensitization studies indicate that negative patients may become positive, not only after therapeutic administration [15,16,20] but also after non-therapeutic exposure to betalactams [21].…”
Subjects with selective IgE responses to side-chain-specific determinants seem to become negative, with no influence from subsequent administration of a closely related penicillin.
“…The availability of diagnostic tests and determination of specific IgE antibodies has made it possible to study this model in great detail [1]. Clinical experience with such patients indicates that reactions can be induced by very low concentrations of drugs through the oral route, skin testing or inadvertent exposures [43][44][45]. If a subject takes amoxicillin or another BL derivative and develops an anaphylactic response after an interval of over 1 h, we are likely dealing with an accelerated reaction for which the proposed mechanism is a T cell response [46•].…”
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