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Proper Cut-off Levels of Serum Specific IgE to Cefaclor for Patients with Cefaclor Allergy

Nam, YH | Lee, SH  | Rhyou, HI | Lee, YS  | Park, SH | Lee, YH | Shin, YS  | Park, HS  | Ye, YM
Yonsei medical journal, 59(8). : 968-974, 2018
Journal Title
Yonsei medical journal
PURPOSE: Cefaclor, a second-generation oral cephalosporin, is known to cause IgE-mediated hypersensitivity. Assays of serum-specific IgE (sIgE) to cefaclor are commercially available via the ImmunoCAP system (Thermo Fisher Scientific). While serum levels of sIgE >0.35 kU/L are considered indicative of an allergy, some patients with cefaclor allergy show low serum IgE levels. This study aimed to evaluate the proper cut-off levels of sIgE in the diagnosis of immediate hypersensitivity to cefaclor.
MATERIALS AND METHODS: A total of 269 patients with drug allergy history, who underwent assays of sIgE to cefaclor at Ajou University hospital and Dong-A University Hospital, were reviewed retrospectively. Among them, 193 patients exhibited cefaclor-induced immediate hypersensitivity with certain or probable causality of an adverse drug reaction according to the WHO-UMC (the World Health Organization-the Uppsala Monitoring Centre) algorithm, and 76 controls showed delayed hypersensitivity reactions to non-antibiotics.
RESULTS: In total, 126 of the 193 patients (65.3%) experienced anaphylaxis: they had higher serum sIgE levels than patients with immediate hypersensitivity who did not experience anaphylaxis (6.36+/-12.39 kU/L vs. 4.28+/-13.61 kU/L, p<0.001). The best cut-off value for cefaclor-induced immediate hypersensitivity was 0.11 kU/L, with sensitivity of 80.2% and specificity of 81.6%. A cut-off value of 0.44 kU/L showed the best sensitivity (75.4%) and specificity (65.7%) for differentiating anaphylaxis from immediate hypersensitivity reactions.
CONCLUSION: Patients with cefaclor anaphylaxis exhibit high serum IgE levels. A cut-off value of 0.11 kU/L of sIgE to cefaclor is proper for identifying patients with cefaclor allergy, and 0.44 kU/L may be useful to detect anaphylaxis.

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Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
Ajou Authors
박, 해심  |  신, 유섭  |  예, 영민  |  이, 소희  |  이, 영수
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