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.
Allergy Unit, Ciudad de Jaén Hospital, Spain. jqe01@saludalia.com
Blanca
B
Sáenz de San Pedro
Cristobalina
C
Mayorga
María José
MJ
Torres
Jose Fernando
JF
Florido
Joaquín
J
Quiralte
Miguel
M
Blanca
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