217 Detection and characterization of human IgE to cephalosporin determinants

Ong, Remedios C.; Sullivan, Tianna

doi:10.1016/0091-6749(88)90452-6

Cited by 16 publications

(3 citation statements)

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“…Patients allergic to benzylpenicillin who have never been administered cephalosporins may have demonstrable antibodies specific to the benzyl side chain, indicating a cross-sensitivity [54,73,74]. However, there is some evidence [75] that coexisting sensitivities may occur.…”

Section: Cross-reactivity To Cephalosporins In Subjects With Ige-medimentioning

confidence: 99%

IgE-Mediated Hypersensitivity to Cephalosporins

Guéant¹,

Guéant-Rodríguez²,

Viola³

et al. 2006

CPD

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Like penicillins, cephalosporins may cause IgE-mediated reactions such as urticaria, angioedema, and anaphylactic shock, which occur because of sensitization to determinants shared with penicillins or to unique cephalosporin haptens. In particular, side-chain structures may be responsible for selective sensitization or cross-reactivity. For this reason, individual free cephalosporins are usually employed in skin testing, in addition to the classic penicillin reagents. Cephalosporin skin tests are sensitive in diagnosing immediate hypersensitivity to these betalactams. As far as in vitro tests are concerned, IgE assays for cephalosporins, specifically sepharose-radioimmunoassays, are a potentially useful tool in evaluating immediate reactions and could be used as complementary tests. In selected cases displaying negative results in both skin tests and IgE assays, a graded challenge with the implicated cephalosporin can be performed. Cephalosporin IgE-mediated hypersensitivity may be a transient condition; therefore, allergologic exams should be repeated in patients with negative initial allergologic work-ups, including challenges. Performing allergologic tests with cephalosporins other than the culprit, as well as with penicillin reagents, allows the identification of cross-reactivity with penicillins, selective responses, or cross-reactivity among cephalosporins. In the latter group, cross-reactivity is more frequently related to R1 than to R2 side-chain recognition. In assessing the selectivity of the response, negative results in skin testing with cephalosporins other than the responsible one appear to be a reliable indicator of tolerability.

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Section: Cross-reactivity To Cephalosporins In Subjects With Ige-medimentioning

confidence: 99%

IgE-Mediated Hypersensitivity to Cephalosporins

Guéant¹,

Guéant-Rodríguez²,

Viola³

et al. 2006

CPD

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“…The possibility of finding coexisting betalactam‐specific IgE antibodies has been suggested [70], although this has never been clearly shown. In our experience, detailed cross‐inhibition studies have not shown coexisting IgE antibodies in the cases of BP, AX, AMP or different cephalosporins [3,30,37].…”

Section: Cross‐reactivity and Coexisting Reactivitymentioning

confidence: 99%

Side‐chain‐specific reactions to betalactams: 14 years later

Blanca

Mayorga

Torres

et al. 2002

Clin Experimental Allergy

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“…Cross-reactivity of penicillins and cephalosporins has been repeatedly reported in vitro [8] and in retrospective studies [10,17]. However, in prospective studies the apparent cross-reactivity appears remarkably less often [11,12] and seems to reflect concurrent but non-crossreactive sensitivity in a small number of highly al lergic individuals presumably due to IgE antibodies to side-chain structures rather than the bicyclic core [8,11]. On this basis the apparent cross-reac tivity between cefotaxime, fosfomycin, and per haps penicillin (history of allergic reaction probab ly to penicillin many years ago) can be explained in our patient.…”

Section: Resultsmentioning

confidence: 99%