Volume 6 Supplement 1
Allergic diseases of the skin and drug allergies – 2026. Immunologic evaluation of the patients with cefaclor hypersensitivity
© Yoo et al; licensee BioMed Central Ltd. 2013
Published: 23 April 2013
Cefaclor is the most common cephalosporin to induce anaphylaxis. We evaluated immunologic findings of cefaclor hypersensitivity.
36 patients with a history of immediate reactions to cefaclor were enrolled from Ajou University Hospital and Asan Medical Center, South Korea. Those with immediate hypersensitivity reactions to cefaclor were defined by a certain clinical history with or without specific IgE to cefaclor by immunoCAP system. Serum specific IgE, IgG1 and IgG4 levels to cefaclor-HSA conjugate were measured by ELISA, and compared with those of ImmunoCAP system. The binding specificity was evaluated by ELISA inhibition test.
Anaphylaxis (group I, 80.6%) was the most common phenotype, followed by urticaria (group II, 19.4%). There were no significant differences in clinical characteristics, such as age, sex and atopy status between group I and II. The serum specific IgE to cefaclor by ImmunoCAP was found in total 29 (80.6%) patients, 24 (82.8%) in group I and 5 (71.4%) in group II with no significant according to clinical parameters. The prevalence of serum specific IgE, and IgG1, IgG4 to cefaclor-HSA conjugate by ELISA tended to be higher in group I (51.7%, 53.6%, 20.7%) than in group II (14.3%, 14.3%, 0%), although these differences were not statistically significant. Serum specific IgG4 to cefaclor-HSA conjugate was observed only in group I. 10.3% patients in group I had high specific IgG1 to cefaclor-HSA conjugate with no specific IgE. Significant associations were found between specific IgE and IgG1 or IgG4 antibodies (p <0.001, p =0.004). ELISA inhibition tests showed significant inhibitions by both free cefalcor and cefaclor-HSA conjugate.
Most common manifestation of immediate hypersensitivities to cefaclor was anaphylaxis in which IgE mediate response is the major pathogenic mechanism. Detection of serum specific E and IgG subtypes to cefaclor-HSA conjugate may be useful to diagnose cefaclor anaphylaxis. The IgG subtype- mediated response was suggested in some cases of cefaclor anaphylaxis.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.