오늘 하루동안 보지 않기
잠시만 기다려 주세요. 로딩중입니다.

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

Yonsei Medical Journal 2018년 59권 8호 p.968 ~ 974
KMID : 0311120180590080968
 ( Nam Young-Hee ) - Dong-A University College of Medicine Department of Internal Medicine

 ( Lee So-Hee ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
 ( Rhyou Hyo-In ) - Dong-A University College of Medicine Department of Internal Medicine
 ( Lee Young-Soo ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
 ( Park Seung-Hee ) - Ajou University Hospital Pharmacovigilance Center
 ( Lee Young-Hee ) - Ajou University Hospital Pharmacovigilance Center
 ( Shin Yoo-Seob ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
 ( Park Hae-Sim ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
 ( Ye Young-Min ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology

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 and Methods: 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.
KeyWords

Anaphylaxis, cefaclor, drug hypersensitivity, specific IgE
원문 및 링크아웃 정보
 
등재저널 정보
SCI(E) MEDLINE 학술진흥재단(KCI) KoreaMed