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Table 2 Relation between clinical reaction (case history) and reaction at penicillin challenge, eliciting penicillin, challenge type and post-challenge levels of s-IgE

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

  Type of reaction Type of challenge Post-challenge s-IgE
Patient no. Case history Challenge Positive 4 weeks later
1 Urticaria (IR) Urticaria (IR) Single p.o Pen V Positive
2 Urticaria (NIR) Maculopapular rash (NIR) Single p.o Pen V Negative
3 Urticaria/angioedema (NIR) Urticaria (NIR) P.o.7 Pen V Positive
4 Urticaria (NIR) Urticaria (NIR) P.o.7 Pen V Negative
5 Urticaria/angioedema (IR) Urticaria (IR) P.o.7 DX Positive
6 Urticaria (NIR) Maculopapular rash (NIR) P.o.7 DX Negative
  1. Bold text indicate concordance between type of reactions eliciting primary reaction and challenge. In the three cases of positive post-challenge s-IgE (no. 1, 3, 5) concordance was found.
  2. In all cases, the culprit drug and the drug eliciting the clinical reaction during challenge were identical (see Table 1).
  3. IR: immediate reaction, NIR: nonimmediate reaction, s-IgE: serum specific IgE to penicillin, p.o.7: 7-day oral challenge, p.o: per oral, Pen V: phenoxymethylpenicillin, DX: dicloxacillin.