Positive serum specific IgE has a short half-life in patients with penicillin allergy and reversal does not always indicate tolerance

Janni Hjortlund; Charlotte Gotthard Mortz; Tore Bjerregaard Stage; Per Stahl Skov; Ronald Dahl; Carsten Bindslev-Jensen

doi:10.1186/2045-7022-4-34

Clinical and Translational Allergy

Table 1 Demographic data and clinical results of the 22 patients with a history of penicillin allergy and with initial positive serum specific IgE to penicillin

From: Positive serum specific IgE has a short half-life in patients with penicillin allergy and reversal does not always indicate tolerance

Patient data*				Primary reaction		Initial IgE						Iv/single dose challenge					Post IgE (4 w after challenge)				Challenge p.o.7				Post IgE (4 w after challenge)
		Age (years)		Primary reaction		Initial IgE						Iv/single dose challenge					Post IgE (4 w after challenge)				Challenge p.o.7				Post IgE (4 w after challenge)
No	Sex	IgE pos	IgE neg	Culprit drug	Type of reaction	Total	Pen V	Pen G	AMP	AX	MDM	Pen G	Pen V	AMP	AX	DX	Pen V	Pen G	AMP	AX	Pen V	AMP	AX	DX	Pen V	Pen G	AMP	AX
1	F	34	35	Penicillin V	urt (IR)	53.1	0.9	0	0	0	0	Neg	Pos	NT	NT	NT	2.8	0	0	0	\	NT	NT	NT	NT	NT	NT	NT
2	M	65	69	Penicillin V	urt (NIR)	248.6	0.4	0	0	0	0	Neg	Pos	NT	NT	NT	0	0	0	0	\	NT	NT	NT	NT	NT	NT	NT
3	M	38	38	Penicillin V	urt+angio (NIR)	101.5	0.5	0	0	0	0	Neg	Neg	NT	NT	NT	0	0	0	0	Pos	NT	NT	NT	0.4	0	0	0
4	M	18	19	Penicillin V	urt (NIR)	54.1	0.4	0	0	0	0	Neg	Neg	NT	NT	NT	0	0	0	0	Pos	NT	NT	NT	0	0	0	0
5	M	56	57	Dicloxacillin	urt+angio (IR)	271.7	0.5	0.4	0.8	0	0	NT	NT	NT	NT	Pos	0.4	0	0.4	0	\	NT	NT	NT	NT	NT	NT	NT
6	M	77	81	Dicloxacillin	rash (NIR)	1773.0	0	0	0.7	0	0	Neg	Neg	NT	NT	Neg	0	0	0	0	Neg	NT	NT	Pos	0	0	0	0
7	F	30	34	Penicillin V	urt (IR)	4.2	0.9	0.8	0	0	0	Neg	Neg	NT	NT	NT	1.2	0.5	0	0	\	NT	NT	NT	NT	NT	NT	NT
8	M	30	33	Penicillin V	urt (IR)	26.8	0.4	0	0	0	0	Neg	Neg	NT	NT	NT	0.8	0	0	0	\	NT	NT	NT	NT	NT	NT	NT
9	M	51	56	Penicillin V	rash (NIR)	580.7	0	0	0.4	0	0	Neg	Neg	NT	NT	NT	0.5	0.7	0	0	\	NT	NT	NT	NT	NT	NT	NT
10	M	43	43	Penicillin V	rash (IR)	10.2	0.4	0	0	0	0	Neg	Neg	NT	NT	NT	0	0	0	0	Neg	NT	NT	NT	>100	0	0	0
11	M	58	58	Penicillin V	urt (IR)	142.7	0.4	0	0	0	0	Neg	Neg	NT	NT	NT	0	0	0	0	Neg	NT	NT	NT	1.5	0.4	0	0
12	F	48	49	Penicillin V	urt+angio (IR)	38.3	0.8	0	0	0	2.3	Neg	Neg	NT	NT	NT	0	0	0	0	Neg	NT	NT	NT	3.9	0	0	0
13	M	51	55	Penicillin V	rash (NIR)	363.7	0.4	0	0	0	0	Neg	Neg	NT	NT	NT	NT	NT	NT	NT	Neg	NT	NT	NT	4.3	0.4	0.4	0
14	F	46	49	Penicillin V	urt+angio (NIR)	4.3	3.4	1.4	0.5	0	0	Neg	Neg	NT	NT	NT	0	0	0	0	Neg	NT	NT	NT	9.8	2.8	2.9	1.3
15	F	34	38	Penicillin V	rash (NIR)	491.2	0	0	0.9	0	0	Neg	Neg	Neg	NT	NT	0	0	0	0	Neg	Neg	NT	NT	0	0	0	0
16	F	63	67	Amoxicillin	rash (NIR)	107.3	0.4	0	0	0	0	Neg	Neg	NT	Neg	NT	0	0	0	0	Neg	NT	Neg	NT	0	0	0	0
17	M	60	61	Amoxicillin	rash (NIR)	698.1	3.2	0	0	0	0	Neg	Neg	NT	NT	NT	0	0	0	0	Neg	NT	Neg	NT	0	0	0	0
18	F	60	67	Amoxicillin	urt (NIR)	NT	0.5	0	0	0	0	Neg	Neg	NT	Neg	NT	0	0	0	0	NT	NT	Neg	NT	0	0	0	0
19	M	52	52	Penicillin V	rash (NIR)	NT	0	0	0.7	0	0	Neg	Neg	Neg	NT	NT	NT	NT	NT	NT	Neg	Neg	NT	NT	NT	NT	NT	NT
20	F	56	61	Amoxicillin	rash (NIR)	NT	1.1	1.0	0	0	0	Neg	Neg	NT	Neg	NT	NT	NT	NT	NT	Neg	NT	Neg	NT	NT	NT	NT	NT
21	F	58	59	Amoxicillin	rash (NIR)	NT	0.4	0	0	0	0	Neg	Neg	NT	Neg	NT	NT	NT	NT	NT	Neg	NT	Neg	NT	NT	NT	NT	NT
22	F	35	43	Penicillin V	urt (NIR)	355.8	0.4	0	0	0	0	Neg	Neg	NT	NT	NT	NT	NT	NT	NT	Neg	NT	NT	NT	NT	NT	NT	NT

*Patient data are illustrating the patients’ age at the time of respective IgE positive and IgE negative results.
F: female, M: male, urt: urticarial, angio: angioedema, p.o.7: 7-day oral challenge, pos: positive challenge, neg: negative challenge, NT: not tested, MDM: Minor determinant mix for penicillin, \: not tested due to either positive i.v./single dose challenge or to positive post-challenge specific IgE to penicillin, bold data: positive result, 0: negative result.

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