Boosted IgE response after anaphylaxis reaction to cefuroxime with cross-reactivity with cefotaxime.
BACKGROUND
Cefuroxime is a second-generation lactamase-stable cephalosporin. Its use is on the increase, and in recent years several reactions to this compound have been reported.


OBJECTIVE
To describe a case of selective reaction to cefuroxime, showing a boosted immunoglobulin (Ig)E response after administration of this drug.


METHODS
Specific serum IgE antibodies to several cephalosporins were monitored in a 52-year-old man after a selective systemic anaphylaxis attributable to cefuroxime, who showed a good tolerance to penicillin V during a single-blind, placebo-controlled challenge.


RESULTS
Specific IgE levels to cefuroxime were not detected at the moment of the reaction but became positive 1 day after, increasing to peak at day 51, and still positive after 115 days. Through radioallergosorbent test inhibition, cross-reactivity between cefuroxime and cefotaxime was demonstrated.


CONCLUSIONS
IgE-mediated reaction attributable to cefuroxime with cross-reactivity to cefotaxime was reported. A prompt evaluation undertaking skin tests and additional radioallergosorbent test studies with different betalactam derivatives improves the evaluation of subjects with allergic reactions to betalactams.
Sáenz de San Pedro
Blanca
B
Allergy Unit, Ciudad de Jaén Hospital, Spain. jqe01@saludalia.com
Mayorga
Cristobalina
C
Torres
María José
MJ
Florido
Jose Fernando
JF
Quiralte
Joaquín
J
Blanca
Miguel
M
D000707:Anaphylaxis / Q000209:etiology*; D002439:Cefotaxime / Q000276:immunology*; D002444:Cefuroxime / Q000276:immunology*; D002511:Cephalosporins / Q000276:immunology*; D003429:Cross Reactions; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged
D002511:Cephalosporins; D007073:Immunoglobulin E; D002439:Cefotaxime; D002444:Cefuroxime