Background
Methods
Patients
Serum elimination half-life (T½) of s-IgE (pen G, V, AMP, AX)
Penicillin challenge in patients with previous positive specific IgE to penicillins
Measurement of specific IgE to penicillins (s-IgE)
Serum elimination half-life (T½) of s-IgE (pen G, V, AMP, AX)
Statistics
Results
Serum elimination half-life (T½) of s-IgE (pen G, V, AMP, AX)
Penicillin challenge in patients with previous positive specific IgE to penicillins
Patient data* | Primary reaction | Initial IgE | Iv/single dose challenge | Post IgE (4 w after challenge) | Challenge p.o.7 | Post IgE (4 w after challenge) | ||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age (years) | ||||||||||||||||||||||||||||
No | Sex | IgE pos | IgE neg | Culprit drug | Type of reaction | Total | Pen V | Pen G | AMP | AX | MDM | Pen G | Pen V | AMP | AX | DX | Pen V | Pen G | AMP | AX | Pen V | AMP | AX | DX | Pen V | Pen G | AMP | AX |
1 | F | 34 | 35 | Penicillin V | urt (IR) | 53.1 |
0.9
| 0 | 0 | 0 | 0 | Neg |
Pos
| NT | NT | NT |
2.8
| 0 | 0 | 0 | \ | NT | NT | NT | NT | NT | NT | NT |
2 | M | 65 | 69 | Penicillin V | urt (NIR) | 248.6 |
0.4
| 0 | 0 | 0 | 0 | Neg |
Pos
| NT | NT | NT | 0 | 0 | 0 | 0 | \ | NT | NT | NT | NT | NT | NT | NT |
3 | M | 38 | 38 | Penicillin V | urt+angio (NIR) | 101.5 |
0.5
| 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | NT | 0 | 0 | 0 | 0 |
Pos
| NT | NT | NT |
0.4
| 0 | 0 | 0 |
4 | M | 18 | 19 | Penicillin V | urt (NIR) | 54.1 |
0.4
| 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | NT | 0 | 0 | 0 | 0 |
Pos
| NT | NT | NT | 0 | 0 | 0 | 0 |
5 | M | 56 | 57 | Dicloxacillin | urt+angio (IR) | 271.7 |
0.5
|
0.4
|
0.8
| 0 | 0 | NT | NT | NT | NT |
Pos
|
0.4
| 0 |
0.4
| 0 | \ | NT | NT | NT | NT | NT | NT | NT |
6 | M | 77 | 81 | Dicloxacillin | rash (NIR) | 1773.0 | 0 | 0 |
0.7
| 0 | 0 | Neg | Neg | NT | NT | Neg | 0 | 0 | 0 | 0 | Neg | NT | NT |
Pos
| 0 | 0 | 0 | 0 |
7 | F | 30 | 34 | Penicillin V | urt (IR) | 4.2 |
0.9
|
0.8
| 0 | 0 | 0 | Neg | Neg | NT | NT | NT |
1.2
|
0.5
| 0 | 0 | \ | NT | NT | NT | NT | NT | NT | NT |
8 | M | 30 | 33 | Penicillin V | urt (IR) | 26.8 |
0.4
| 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | NT |
0.8
| 0 | 0 | 0 | \ | NT | NT | NT | NT | NT | NT | NT |
9 | M | 51 | 56 | Penicillin V | rash (NIR) | 580.7 | 0 | 0 |
0.4
| 0 | 0 | Neg | Neg | NT | NT | NT |
0.5
|
0.7
| 0 | 0 | \ | NT | NT | NT | NT | NT | NT | NT |
10 | M | 43 | 43 | Penicillin V | rash (IR) | 10.2 |
0.4
| 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | NT | 0 | 0 | 0 | 0 | Neg | NT | NT | NT |
>100
| 0 | 0 | 0 |
11 | M | 58 | 58 | Penicillin V | urt (IR) | 142.7 |
0.4
| 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | NT | 0 | 0 | 0 | 0 | Neg | NT | NT | NT |
1.5
|
0.4
| 0 | 0 |
12 | F | 48 | 49 | Penicillin V | urt+angio (IR) | 38.3 |
0.8
| 0 | 0 | 0 |
2.3
| Neg | Neg | NT | NT | NT | 0 | 0 | 0 | 0 | Neg | NT | NT | NT |
3.9
| 0 | 0 | 0 |
13 | M | 51 | 55 | Penicillin V | rash (NIR) | 363.7 |
0.4
| 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | NT | NT | NT | NT | NT | Neg | NT | NT | NT |
4.3
|
0.4
|
0.4
| 0 |
14 | F | 46 | 49 | Penicillin V | urt+angio (NIR) | 4.3 |
3.4
|
1.4
|
0.5
|
0
| 0 | Neg | Neg | NT | NT | NT | 0 | 0 | 0 | 0 | Neg | NT | NT | NT |
9.8
|
2.8
|
2.9
|
1.3
|
15 | F | 34 | 38 | Penicillin V | rash (NIR) | 491.2 | 0 | 0 |
0.9
| 0 | 0 | Neg | Neg | Neg | NT | NT | 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | 0 | 0 | 0 | 0 |
16 | F | 63 | 67 | Amoxicillin | rash (NIR) | 107.3 |
0.4
| 0 | 0 | 0 | 0 | Neg | Neg | NT | Neg | NT | 0 | 0 | 0 | 0 | Neg | NT | Neg | NT | 0 | 0 | 0 | 0 |
17 | M | 60 | 61 | Amoxicillin | rash (NIR) | 698.1 |
3.2
| 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | NT | 0 | 0 | 0 | 0 | Neg | NT | Neg | NT | 0 | 0 | 0 | 0 |
18 | F | 60 | 67 | Amoxicillin | urt (NIR) | NT |
0.5
| 0 | 0 | 0 | 0 | Neg | Neg | NT | Neg | NT | 0 | 0 | 0 | 0 | NT | NT | Neg | NT | 0 | 0 | 0 | 0 |
19 | M | 52 | 52 | Penicillin V | rash (NIR) | NT | 0 | 0 |
0.7
| 0 | 0 | Neg | Neg | Neg | NT | NT | NT | NT | NT | NT | Neg | Neg | NT | NT | NT | NT | NT | NT |
20 | F | 56 | 61 | Amoxicillin | rash (NIR) | NT |
1.1
|
1.0
| 0 | 0 | 0 | Neg | Neg | NT | Neg | NT | NT | NT | NT | NT | Neg | NT | Neg | NT | NT | NT | NT | NT |
21 | F | 58 | 59 | Amoxicillin | rash (NIR) | NT |
0.4
| 0 | 0 | 0 | 0 | Neg | Neg | NT | Neg | NT | NT | NT | NT | NT | Neg | NT | Neg | NT | NT | NT | NT | NT |
22 | F | 35 | 43 | Penicillin V | urt (NIR) | 355.8 |
0.4
| 0 | 0 | 0 | 0 | Neg | Neg | NT | NT | NT | NT | NT | NT | NT | Neg | NT | NT | NT | NT | NT | NT | NT |
Type of reaction | Type of challenge | Post-challenge s-IgE | ||
---|---|---|---|---|
Patient no. | Case history | Challenge | Positive | 4 weeks later |
1 |
Urticaria (IR)
|
Urticaria (IR)
| Single p.o Pen V | Positive |
2 | Urticaria (NIR) | Maculopapular rash (NIR) | Single p.o Pen V | Negative |
3 |
Urticaria/angioedema (NIR)
|
Urticaria (NIR)
| P.o.7 Pen V | Positive |
4 |
Urticaria (NIR)
|
Urticaria (NIR)
| P.o.7 Pen V | Negative |
5 |
Urticaria/angioedema (IR)
|
Urticaria (IR)
| P.o.7 DX | Positive |
6 | Urticaria (NIR) | Maculopapular rash (NIR) | P.o.7 DX | Negative |
I.v/single p.o (pen V,G) (n = 21)** | P.o.7 (pen V) (n = 15)* | Single p.o (other) (n = 8)* | P.o.7 (other) (n = 8)* | ||||||
---|---|---|---|---|---|---|---|---|---|
Pos (n = 2) | Neg (n = 19) | Pos (n = 2) | Neg (n = 13) | Pos (n = 1) | Neg (n = 7) | Pos (n = 1) | Neg (n = 7) | ||
Post-challenge s-IgE
|
Pos (n = 11)
| 1 | 3 | 1 | 5 | 1** | 0 | 0 | 0 |
Neg (n = 25)
| 1 | 11* | 1 | 4 | 0 | 4 | 1 | 4* | |
NT (n = 12)
| 0 | 5 | 0 | 4 | 0 | 3 | 0 | 3 |