PMID- 36916097
OWN - NLM
STAT- MEDLINE
DCOM- 20230315
LR  - 20230315
IS  - 1578-1267 (Electronic)
IS  - 0301-0546 (Linking)
VI  - 51
IP  - 2
DP  - 2023
TI  - A case of persistent IgE sensitisation almost two decades following ampicillin 
      anaphylaxis.
PG  - 126-129
LID - 10.15586/aei.v51i2.748 [doi]
AB  - BACKGROUND: Although most immunoglobulin E (IgE)-mediated penicillin allergy 
      wanes with time, sensitisation may occasionally persist for many years. Previous 
      reports on the loss of penicillin-specific IgE sensitisation were based on 
      non-anaphylaxis cases and, although uncommon, persistent sensitisation may still 
      be possible in the minority of cases. OBJECTIVE: This case highlights that 
      irrespective of the elapsed duration since the index reaction, it is important to 
      remain vigilant when approaching patients with a history of severe reactions. 
      MATERIAL AND METHODS: We described a case of persistent IgE sensitisation almost 
      two decades following ampicillin anaphylaxis. RESULTS: A 78-year-old male with a 
      history of perioperative penicillin anaphylaxis in 2003 was referred for allergy 
      workup in 2022 before his knee joint replacement surgery. The patient had 
      strictly avoided all beta-lactams since the index reaction. However, his 
      penicillin-specific sensitisation persisted, evidenced by positive skin tests 
      (with generalised urticaria after intradermal testing) and basophil activation 
      tests. CONCLUSION: To our knowledge, this was the first case of positive BAT 
      tested around two decades following the index reaction. This case illustrates 
      that a cautious approach may still be warranted in patients with a history of 
      severe reaction to penicillin regardless of the duration since the reported index 
      reaction.
FAU - Au, Elaine Yl
AU  - Au EY
AD  - Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, 
      The University of Hong Kong, Hong Kong.
FAU - Chiang, Valerie
AU  - Chiang V
AD  - Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, 
      The University of Hong Kong, Hong Kong.
FAU - Kan, Andy Ka Chun
AU  - Kan AKC
AD  - Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen 
      Mary Hospital, The University of Hong Kong, Hong Kong.
FAU - Lam, Ki
AU  - Lam K
AD  - Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, 
      The University of Hong Kong, Hong Kong.
FAU - Wong, Jane Cy
AU  - Wong JC
AD  - Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen 
      Mary Hospital, The University of Hong Kong, Hong Kong.
FAU - Yeung, Heather Hy
AU  - Yeung HH
AD  - Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, 
      The University of Hong Kong, Hong Kong.
FAU - Li, Philip Hei
AU  - Li PH
AD  - Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen 
      Mary Hospital, The University of Hong Kong, Hong Kong; liphilip@hku.hk.
LA  - eng
PT  - Case Reports
DEP - 20230301
PL  - Singapore
TA  - Allergol Immunopathol (Madr)
JT  - Allergologia et immunopathologia
JID - 0370073
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 7C782967RD (Ampicillin)
RN  - 0 (Penicillins)
SB  - IM
MH  - Male
MH  - Humans
MH  - Aged
MH  - Immunoglobulin E
MH  - Skin Tests
MH  - Ampicillin/adverse effects
MH  - Penicillins/adverse effects
MH  - *Drug Hypersensitivity/diagnosis
MH  - *Anaphylaxis/diagnosis/chemically induced
OTO - NOTNLM
OT  - allergy
OT  - anaphylaxis
OT  - basophil activation test
OT  - penicillins
OT  - specific IgE
COIS- The authors declare no potential conflicts of interest with respect to research, 
      authorship, and/or publication of this article.
EDAT- 2023/03/15 06:00
MHDA- 2023/03/16 06:00
CRDT- 2023/03/14 03:23
PHST- 2022/08/04 00:00 [received]
PHST- 2022/12/21 00:00 [accepted]
PHST- 2023/03/14 03:23 [entrez]
PHST- 2023/03/15 06:00 [pubmed]
PHST- 2023/03/16 06:00 [medline]
AID - 10.15586/aei.v51i2.748 [doi]
PST - epublish
SO  - Allergol Immunopathol (Madr). 2023 Mar 1;51(2):126-129. doi: 
      10.15586/aei.v51i2.748. eCollection 2023.