1. Academic Validation
  2. Immunologic evaluation of immediate hypersensitivity to cefaclor

Immunologic evaluation of immediate hypersensitivity to cefaclor

  • Yonsei Med J. 2014 Nov;55(6):1473-83. doi: 10.3349/ymj.2014.55.6.1473.
Hye-Soo Yoo 1 Seung-Hyun Kim 1 Hyouk-Soo Kwon 2 Tae-Bum Kim 2 Young-Hee Nam 3 Young-Min Ye 1 Hae-Sim Park 4
Affiliations

Affiliations

  • 1 Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
  • 2 Division of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3 Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
  • 4 Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea. hspark@ajou.ac.kr.
Abstract

Purpose: Cefaclor is widely prescribed for various infectious diseases. As its consumption increases, the number of hypersensitivity reactions to cefaclor has increased. This study aimed to evaluate the immunologic findings of immediate hypersensitivity to cefaclor.

Materials and methods: We enrolled 47 patients with immediate hypersensitivity to cefaclor from Ajou University Hospital and Asan Medical Center. Serum specific IgE, IgG1, and IgG4 Antibodies to cefaclor-human serum albumin (HSA) conjugate were measured by enzyme-linked immunosorbent assay (ELISA).

Results: The most common phenotype was anaphylaxis (Group I, 78.7%), followed by urticaria (Group II, 21.3%). The detection of specific IgE, IgG1, and IgG4 to cefaclor-HSA conjugate by ELISA tended to be higher in Group I (40.5%, 41.7%, 21.6%) than in Group II (20.0%, 20.0%, 0%) with no statistical significance. Significant associations were found between specific IgE and IgG1 or IgG4 (p<0.001, p=0.019). ELISA inhibition tests showed significant inhibitions by both free cefaclor and cefaclor-HSA conjugate. For basophil activation tests in patients having no specific IgE antibody, the CD63 expression level on basophils increased with incubations of free cefaclor.

Conclusion: The most common manifestation of immediate hypersensitivity to cefaclor was anaphylaxis, most of which was mediated by IgE; however, a non-IgE mediated direct basophil activation mechanism was suggested in a subset of anaphylaxis patients.

Keywords

Cefaclor; IgE; IgG; anaphylaxis; hypersensitivity; immediate; urticaria.

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