$beta;-lactam allergy in clinical practice, relevance of clinical history and/or laboratory test*1
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185 β-Lactam Allergy in Clinical Practice, Relevance of Clinical History and/or Laboratory Test B. Arnoux 1 , V. Kvedariene 2 , M. Rongier 1 , J. Bousquet 1 , P. Demoly 3 ; 1 U454, INSERM, Montpellier Cedex 05, FRANCE, 2 U454, CHU Mont- pellier, Montpellier Cedex 05, FRANCE, 3 Education Natoinale, Montpel- lier Cedex 05, FRANCE. RATIONALE: Hypersensitivity reactions to β-lactam are common and may be severe, these include immediate (IgE-mediated) and non-immedi- ate reactions. The value of biological test like; basophil degranulation test, in a non-selected population of patients suspected of drug allergy has never been fully established. METHODS: We randomly studied 35 patients who consulted for a sus- pected immediate hypersensitivity reaction to β-lactams. Clinical history, skin tests or drug provocation test (DPT) and/or serum specific IgE anti- bodies were performed to establish the diagnosis of allergy to β-lactam. The Basotest‚ based upon the expression of CD63 in the presence of spe- cific allergens was evaluated as biological test to confirmed the clinical analysis in this unselected population. 35 β-lactam suspected allergic patients (13 urticaria, 9 macula papular eruption, 7 choc, 3 angioedema), 40 atopic subjects non-allergic to β-lactam were studied. History, provo- cation test and Basotest‚ to detect a specific sensitization to β-lactam were studied in all subjects. RESULTS: No statistical difference in the basal CD63 expression was observed between basophils of β-lactam allergic patients and those from control subject. In the 35 β-lactam allergic patients, Basotest‚ was positive in 3 subjects, two with a confirmed allergy (amoxicillin or ceftriaxon) and another one with a negative DPT (ceftriaxon), all control were negative. CONCLUSION: This study does not confirm the data of Sanz et al (Clin Exp Allergy 2002) who used a different method of activation of basophils and analysis method. Thus, the Basotest® cannot be used in patients with immediate hypersensitivity reactions to β-lactams. Funding: INSERM, France J ALLERGY CLIN IMMUNOL Abstracts S71 VOLUME 113, NUMBER 2 SATURDAY
Transcript of $beta;-lactam allergy in clinical practice, relevance of clinical history and/or laboratory test*1
185 β-Lactam Allergy in Clinical Practice, Relevance of ClinicalHistory and/or Laboratory Test
B. Arnoux1, V. Kvedariene2, M. Rongier1, J. Bousquet1, P. Demoly3;1U454, INSERM, Montpellier Cedex 05, FRANCE, 2U454, CHU Mont-pellier, Montpellier Cedex 05, FRANCE, 3Education Natoinale, Montpel-lier Cedex 05, FRANCE.RATIONALE: Hypersensitivity reactions to β-lactam are common andmay be severe, these include immediate (IgE-mediated) and non-immedi-ate reactions. The value of biological test like; basophil degranulation test,in a non-selected population of patients suspected of drug allergy hasnever been fully established.METHODS: We randomly studied 35 patients who consulted for a sus-pected immediate hypersensitivity reaction to β-lactams. Clinical history,skin tests or drug provocation test (DPT) and/or serum specific IgE anti-bodies were performed to establish the diagnosis of allergy to β-lactam.The Basotest‚ based upon the expression of CD63 in the presence of spe-cific allergens was evaluated as biological test to confirmed the clinicalanalysis in this unselected population. 35 β-lactam suspected allergicpatients (13 urticaria, 9 macula papular eruption, 7 choc, 3 angioedema),40 atopic subjects non-allergic to β-lactam were studied. History, provo-cation test and Basotest‚ to detect a specific sensitization to β-lactam werestudied in all subjects.RESULTS: No statistical difference in the basal CD63 expression wasobserved between basophils of β-lactam allergic patients and those fromcontrol subject. In the 35 β-lactam allergic patients, Basotest‚ was positivein 3 subjects, two with a confirmed allergy (amoxicillin or ceftriaxon) andanother one with a negative DPT (ceftriaxon), all control were negative.CONCLUSION: This study does not confirm the data of Sanz et al (ClinExp Allergy 2002) who used a different method of activation of basophilsand analysis method. Thus, the Basotest® cannot be used in patients withimmediate hypersensitivity reactions to β-lactams.Funding: INSERM, France
J ALLERGY CLIN IMMUNOL Abstracts S71VOLUME 113, NUMBER 2
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