Proper Cut-off Levels of Serum Specific IgE to Cefaclor for Patients with Cefaclor Allergy.
10.3349/ymj.2018.59.8.968
- Author:
Young Hee NAM
1
;
So Hee LEE
;
Hyo In RHYOU
;
Young Soo LEE
;
Seung Hee PARK
;
Young Hee LEE
;
Yoo Seob SHIN
;
Hae Sim PARK
;
Young Min YE
Author Information
1. Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Anaphylaxis;
cefaclor;
drug hypersensitivity;
specific IgE
- MeSH:
Anaphylaxis;
Cefaclor*;
Diagnosis;
Drug Hypersensitivity;
Drug-Related Side Effects and Adverse Reactions;
Global Health;
Humans;
Hypersensitivity*;
Hypersensitivity, Delayed;
Hypersensitivity, Immediate;
Immunoglobulin E*;
Retrospective Studies;
Sensitivity and Specificity
- From:Yonsei Medical Journal
2018;59(8):968-974
- CountryRepublic of Korea
- Language:English
-
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.
