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

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

Young Hee Nam, So Hee Lee, Hyo In Rhyou, Young Soo Lee, Seung Hee Park, Young Hee Lee, Yoo Seob Shin, Hae Sim Park, Young Min Ye

Yonsei Med J. 2018 Oct;59(8):968-974.

PMID: 30187704

Abstract:

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.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP70356035-A	Cefaclor		70356-03-5	Price

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