Proper Cut-off Levels of Serum Specific IgE to Cefaclor for Patients with Cefaclor Allergy
Yonsei Medical Journal
;
: 968-974, 2018.
Article
in English
| WPRIM
| ID: wpr-717932
ABSTRACT
PURPOSE:
Cefaclor, 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 ANDMETHODS:
A 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.RESULTS:
In 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.CONCLUSION:
Patients 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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Immunoglobulin E
/
Cefaclor
/
Global Health
/
Retrospective Studies
/
Sensitivity and Specificity
/
Diagnosis
/
Drug Hypersensitivity
/
Drug-Related Side Effects and Adverse Reactions
/
Hypersensitivity
/
Hypersensitivity, Delayed
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Yonsei Medical Journal
Year:
2018
Type:
Article
Similar
MEDLINE
...
LILACS
LIS