Diagnosis of antibody‐mediated drug allergy

Abstract

Based on the 1-phenyl-2,3-dimethyl-3-pyrazolin-5-one series and on the 1,2-diphenyl-pyrazolidine-3,5-dione series of drugs, haptenic reagents and conjugates were synthesized and evaluated by passive cutaneous anaphylaxis in guinea pigs, and by ELISA tests using rabbit antisera against the haptens. No cross-reactivity between pyrazolinone and pyrazolidinedione haptenic reagents was found in any of the test systems. But also within each series, the animal antibodies showed rather strict specificities upon interaction with related haptens or drugs. These results are somewhat unexpected, because the haptens were used in connection with long and flexible spacer arms. Furthermore, they are not typical for certain other drug allergies. The strict specificity reduces the diagnostic potential of the haptenic reagents when used in serological tests or in skin testing.

Allergic Reactions to Metamizole: Immediate and Delayed Responses

“…There are only a few experimental studies on the quantification of IgE antibodies, and no detailed studies have been carried out in this field [8,9,10]. For delayed reactions, positive delayed ID and/or patch tests to the culprit drug with a characteristic T-cell infiltrate have been reported [6,34,35,36,37,38].…”

“…Metamizole has more than 20 known metabolites [31] formed by either alkaline hydrolysis or biotransformation, but only a few studies have analyzed their immunogenic potential [8,44]. The identification of the adequate metabolite may be necessary to identify the underlying mechanisms and better diagnose these patients.…”

“…The last two categories involve an immunologically mediated response that is induced by a single drug/drug group, with subjects tolerating other chemically unrelated compounds (selective response) including strong COX-1 inhibitors [5,6]. In SNIUAA, symptoms usually occur shortly after drug intake [5] and an IgE-mediated mechanism has been proposed [7,8,9,10]. In SNIDHR, reactions occur 24-48 h or longer after drug intake [5] and a T cell-mediated mechanism is likely [11].…”

A Toxicological Assessment of Sulfur as a Pesticide

“…Two case reports implicate elemental sulfur as a human contact allergen. Schneider (1978) reported two cases of contact allergy in patients who used medications containing elemental sulfur to treat superficial fungal dermatoses. Both patients had positive patch test reactions to 5% elemental sulfur in series of vehicles, but a control series was not reported.…”

Basic aspects related to penicillin‐allergy skin testing: on the variability of the hapten‐paratope interaction

“…We have previously used in several instances, as in other studies (12,19), direct attachment of haptens to ELISA plates not involving a protein carrier in order to benefit from well-defined specificities of interaction. We feel that the use of multiplehaptenated polylysines is even better because, due to a cluster effect, enhanced affinities come into play (20).…”