Predominant patterns of β-lactam hypersensitivity in a single German Allergy Center: exanthem induced by aminopenicillins, anaphylaxis by cephalosporins.
Predominant patterns of β-lactam hypersensitivity in a single German Allergy Center: exanthem induced by aminopenicillins, anaphylaxis by cephalosporins.
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德国过敏中心β-内酰胺超敏反应的主要模式：氨基青霉素引起的皮疹、头孢菌素引起的过敏反应。
DOI：
10.1186/s13223-020-00488-0
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发表时间：
2020-11-17
期刊：
影响因子：
--
通讯作者：
Trautmann A
中科院分区：
文献类型：
--
作者：
Schrüfer P;Brockow K;Stoevesandt J;Trautmann A
青霉素类和其他β-内酰胺类抗生素是最常见的过敏性药物反应诱发剂。然而，关于特定β-内酰胺类药物引起的临床反应类型模式的数据很少且不一致。我们的目的是确定β-内酰胺过敏的模式，即临床反应类型与特定β-内酰胺抗生素的相关性。我们回顾性评价了来自一家德国过敏中心11年内800例疑似β-内酰胺超敏反应的连续患者的数据。595例患者明确排除β-内酰胺类过敏，70例诊断为速发型（推测为IgE介导）过敏，135例诊断为迟发型过敏。大多数（59/70，84.3%）速发型过敏反应是由有限数量的头孢菌素引起的。迟发性反应通常由氨基青霉素引起（127/135，94.1%），通常表现为麻疹样皮疹（117/135，86.7%）。皮内试验被证明是诊断β-内酰胺过敏最有用的方法，但在70例速发型超敏反应患者中，24例（34.3%）点刺试验已呈阳性。除皮内试验外，斑贴试验未提供诊断迟发型超敏反应的额外信息。几乎所有β-内酰胺过敏患者都能耐受至少一种，通常是几种β-内酰胺类替代物质。我们确定了两种β-内酰胺超敏反应模式：氨基青霉素诱导的皮疹和某些头孢菌素引发的过敏反应。皮内皮肤试验是检测IgE介导的和迟发型β-内酰胺超敏反应的最有用的方法。
Penicillins and other β-lactam antibiotics are the most common elicitors of allergic drug reaction. However, data on the pattern of clinical reaction types elicited by specific β-lactams are scarce and inconsistent. We aimed to determine patterns of β-latam allergy, i.e. the association of a clinical reaction type with a specific β-lactam antibiotic. We retrospectively evaluated data from 800 consecutive patients with suspected β-lactam hypersensitivity over a period of 11 years in a single German Allergy Center. β-lactam hypersensitivity was definitely excluded in 595 patients, immediate-type (presumably IgE-mediated) hypersensitivity was diagnosed in 70 and delayed-type hypersensitivity in 135 cases. Most (59 out of 70, 84.3%) immediate-type anaphylactic reactions were induced by a limited number of cephalosporins. Delayed reactions were regularly caused by an aminopenicillin (127 out of 135, 94.1%) and usually manifested as a measles-like exanthem (117 out of 135, 86.7%). Intradermal testing proved to be the most useful method for diagnosing β-lactam allergy, but prick testing was already positive in 24 out of 70 patients with immediate-type hypersensitivity (34.3%). Patch testing in addition to intradermal testing did not provide additional information for the diagnosis of delayed-type hypersensitivity. Almost all β-lactam allergic patients tolerated at least one, usually several alternative substances out of the β-lactam group. We identified two patterns of β-lactam hypersensitivity: aminopenicillin-induced exanthem and anaphylaxis triggered by certain cephalosporins. Intradermal skin testing was the most useful method to detect both IgE-mediated and delayed-type β-lactam hypersensitivity.
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影响因子：
12.4
作者：
Ponvert, C.;Weilenmann, C.;Scheinmann, P.
通讯作者：
Scheinmann, P.
影响因子：
6.1
作者：
Trautmann, A.;Seitz, C. S.;Kerstan, A.
通讯作者：
Kerstan, A.
影响因子：
12.4
作者：
Mayorga, C.;Celik, G.;Torres, M. J.
通讯作者：
Torres, M. J.
影响因子：
5.5
作者：
H채usermann, P;Harr, T;Bircher, AJ
通讯作者：
Bircher, AJ
影响因子：
12.4
作者：
Aberer, W;Bircher, A;Demoly, P
通讯作者：
Demoly, P