Immunologic Evaluation of Immediate Hypersensitivity to Cefaclor

Yoo, Hye-Soo; Kim, Seung Hyun; Kwon, Hyouk‐Soo; Kim, Tae‐Bum; Nam, Young‐Hee; Ye, Young-Min; Park, Hae‐Sim

doi:10.3349/ymj.2014.55.6.1473

Cited by 11 publications

(14 citation statements)

References 53 publications

(83 reference statements)

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“…The incidence of ranitidine‐induced anaphylaxis was 3.6 times higher than the incidence reported in a previous study . There is a possibility that the incidence has increased over time, similar to cefaclor anaphylaxis . The study was based on a self‐reported database that may have underestimated the true incidence in Korea.…”

Section: Discussionmentioning

confidence: 83%

Ranitidine‐induced anaphylaxis: clinical features, cross‐reactivity, and skin testing

Park

Pai

Song³

et al. 2016

Clin Experimental Allergy

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Section: Discussionmentioning

confidence: 83%

Ranitidine‐induced anaphylaxis: clinical features, cross‐reactivity, and skin testing

Park

Pai

Song³

et al. 2016

Clin Experimental Allergy

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“… 8 11 Compared with a lower sensitivity (36.2%) for detecting serum sIgE to cefaclor-albumin conjugate by homemade ELISA, ImmunoCAP has been found to show a higher sensitivity (89.4%) for detecting cefaclor allergy at a cut-off value of 0.35 kU/L. 7 …”

Section: Discussionmentioning

confidence: 99%

“…Skin testing and measurement of serum-specific IgE (sIgE) levels to cefaclor have been well documented. 3 5 6 7 Skin testing is the primary diagnostic method, although, in patients with a history of severe reactions, in vitro tests may be recommended.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, sIgE to cefaclor can be measured by the commercially available ImmunoCAP system (Thermo Fisher Scientific, Uppsala, Sweden), with high detection rates (80–90%). 5 7 Serum sIgE levels >0.35 kU/L against allergens measured by ImmunoCAP are regarded as indicating positivity to allergen, regardless of type, such as foods, inhalants, and drugs, and clinical manifestations, including urticarial, skin rash, and anaphylaxis. However, in real practice, some patients with hypersensitivity to cefaclor show low IgE levels below 0.35 kU/L.…”

Section: Introductionmentioning

confidence: 99%

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Proper Cut-off Levels of Serum Specific IgE to Cefaclor for Patients with Cefaclor Allergy

et al. 2018

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PurposeCefaclor, a second-generation oral cephalosporin, is known to cause IgE-mediated hypersensitivity. Assays of serum-specific IgE (sIgE) to cefaclor are commercially available via the ImmunoCAP system (Thermo Fisher Scientific). While serum levels of sIgE >0.35 kU/L are considered indicative of an allergy, some patients with cefaclor allergy show low serum IgE levels. This study aimed to evaluate the proper cut-off levels of sIgE in the diagnosis of immediate hypersensitivity to cefaclor.Materials and MethodsA total of 269 patients with drug allergy history, who underwent assays of sIgE to cefaclor at Ajou University hospital and Dong-A University Hospital, were reviewed retrospectively. Among them, 193 patients exhibited cefaclor-induced immediate hypersensitivity with certain or probable causality of an adverse drug reaction according to the WHO-UMC (the World Health Organization-the Uppsala Monitoring Centre) algorithm, and 76 controls showed delayed hypersensitivity reactions to non-antibiotics.ResultsIn total, 126 of the 193 patients (65.3%) experienced anaphylaxis; they had higher serum sIgE levels than patients with immediate hypersensitivity who did not experience anaphylaxis (6.36±12.39 kU/L vs. 4.28±13.61 kU/L, p<0.001). The best cut-off value for cefaclor-induced immediate hypersensitivity was 0.11 kU/L, with sensitivity of 80.2% and specificity of 81.6%. A cut-off value of 0.44 kU/L showed the best sensitivity (75.4%) and specificity (65.7%) for differentiating anaphylaxis from immediate hypersensitivity reactions.ConclusionPatients with cefaclor anaphylaxis exhibit high serum IgE levels. A cut-off value of 0.11 kU/L of sIgE to cefaclor is proper for identifying patients with cefaclor allergy, and 0.44 kU/L may be useful to detect anaphylaxis.

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“…The two main allergic responses are urticarial and anaphylaxis [3]. Many serum sickness type reactions to cefaclor have been reported [4,5]. Patients administered cefaclor had a higher frequency of serum sickness type reactions and urticaria than those prescribed amoxicillin [6].…”

Section: Introductionmentioning

confidence: 99%

Immunotherapy Using IFN-Gamma for Cefaclor Allergy: Case Reports

Noh¹,

Kim²,

Kim³

et al. 2018

J Allergy Ther

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Cefaclor is prescribed worldwide and is one of the most frequently prescribed oral antibiotics. Several allergic reactions to cefaclor were reported. Desensitization for cefaclor allergy has been attempted and not all desensitization of cefaclor has been successful. IFN-gamma has been used for the tolerance induction for food allergies of both IgE-mediated and non-IgE mediated type. IFN-gamma was reported to have tolerogenic effects for allergen-specific allergies. Recently, IFN-gamma was introduced for desensitization for aspirin in acute myocardial syndrome. In this case report, two cases of patients who had anaphylactic allergies to cefaclor and treated successfully by desensitization using IFN-gamma were reported.

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Immunologic Evaluation of Immediate Hypersensitivity to Cefaclor

Cited by 11 publications

References 53 publications

Ranitidine‐induced anaphylaxis: clinical features, cross‐reactivity, and skin testing

Ranitidine‐induced anaphylaxis: clinical features, cross‐reactivity, and skin testing

Proper Cut-off Levels of Serum Specific IgE to Cefaclor for Patients with Cefaclor Allergy

Immunotherapy Using IFN-Gamma for Cefaclor Allergy: Case Reports

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