PMID- 17156341
OWN - NLM
STAT- MEDLINE
DCOM- 20070508
LR  - 20061212
IS  - 0105-4538 (Print)
IS  - 0105-4538 (Linking)
VI  - 62
IP  - 1
DP  - 2007 Jan
TI  - Relevance of the determination of serum-specific IgE antibodies in the diagnosis 
      of immediate beta-lactam allergy.
PG  - 47-52
AB  - BACKGROUND: Allergic reactions to beta-lactams are the most frequent cause of 
      adverse drug reactions mediated by specific immunologic mechanisms. They can be 
      explored by in vivo and/or in vitro tests. The measurement of serum-specific 
      immunoglobulin E (IgE) presents several advantages: safety, simplicity, and 
      availability to nonallergologist physicians. OBJECTIVES: To establish the 
      diagnostic value of specific IgE determination in the diagnosis procedure of 
      immediate beta-lactam allergy. METHODS: The in vitro determination of 
      beta-lactam-specific IgE antibodies was compared in three well-defined groups of 
      patients (n=45): one with negative skin tests and a positive drug provocation 
      test, another with positive skin tests, and a third control exposed population 
      with good tolerance. Two techniques were used: the CAP-FEIA system (Phadia) 
      commercially available and a homemade radioallergosorbent test (RAST). RESULTS: 
      The specificity of CAP-FEIA ranged from 83.3% to 100% and sensitivity from 0% to 
      25% depending on initial clinical manifestations. The specificity of RAST was 
      between 66.7% and 83.3% and sensitivity 42.9% and 75%. In the subgroup of 
      patients with an anaphylactic shock and negative skin tests, the sensitivity and 
      specificity of RAST were 75%. Positive and negative predictive values were 45.5% 
      and 77.1% with CAP-FEIA and 38.5% and 81.5% with RAST, respectively. CONCLUSION: 
      These results indicate that, although the specificity of beta-lactam-specific IgE 
      measurement is good, sensitivity is low. Immunoglobulin E measurement should be 
      limited to patients with a clinical history of anaphylactic shock and negative 
      skin tests in order to avoid a drug provocation test. More sensitive assays 
      should be developed.
FAU - Fontaine, C
AU  - Fontaine C
AD  - Exploration des allergies - Maladies Respiratoires and INSERM U454 - IFR3, 
      Hopital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier 
      Cedex 5, France.
FAU - Mayorga, C
AU  - Mayorga C
FAU - Bousquet, P J
AU  - Bousquet PJ
FAU - Arnoux, B
AU  - Arnoux B
FAU - Torres, M-J
AU  - Torres MJ
FAU - Blanca, M
AU  - Blanca M
FAU - Demoly, P
AU  - Demoly P
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 0 (Cephalosporins)
RN  - 0 (Penicillins)
RN  - 0 (beta-Lactams)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cephalosporins/adverse effects/immunology
MH  - Child
MH  - Drug Hypersensitivity/*diagnosis
MH  - Female
MH  - Humans
MH  - Hypersensitivity, Immediate/*diagnosis
MH  - Immunoglobulin E/*blood
MH  - Male
MH  - Middle Aged
MH  - Penicillins/adverse effects/immunology
MH  - Predictive Value of Tests
MH  - Sensitivity and Specificity
MH  - Skin Tests
MH  - beta-Lactams/*adverse effects/*immunology
EDAT- 2006/12/13 09:00
MHDA- 2007/05/09 09:00
CRDT- 2006/12/13 09:00
PHST- 2006/12/13 09:00 [pubmed]
PHST- 2007/05/09 09:00 [medline]
PHST- 2006/12/13 09:00 [entrez]
AID - ALL1268 [pii]
AID - 10.1111/j.1398-9995.2006.01268.x [doi]
PST - ppublish
SO  - Allergy. 2007 Jan;62(1):47-52. doi: 10.1111/j.1398-9995.2006.01268.x.