PPL and MDM skin test: new test kit is helpful in detecting immediate-type allergy to beta-lactams.
BACKGROUND
The diagnosis of PPL (major determinant) and MDM (minor determinant) sensitization as relevant allergens in beta-lactam allergy has been recently hampered by withdrawal from the market of formerly available test kits. We investigated a new PPL/MDM test kit in the work-up of beta-lactam allergy.


METHODS
15 patients with history of beta-lactam allergy were investigated for specific IgE and received patch, skin prick (SPT) and intracutaneous tests (ICT; immediate and late readings) using the relevant beta-lactams. In addition the new test kit was used for parallel SPT and ICT.


RESULTS
14 women and 1 man (16-73 years) with immediate (n = 7), delayed (n = 7) or unclear (n = 1) reactions to beta-lactams 8-300 months previously (penicillin G/V n = 3, aminopenicillins n = 7, cephalosporins n = 4, unknown n = 2) were tested. In patients with immediate type reactions, n = 2 had specific IgE, n = 4 reacted to the new test kit (n = 3 MDM, all of whom reacted exclusively to this test, n = 1 PPL). Two patients with non-immediate reactions reacted to other beta-lactams.


CONCLUSIONS
Our data show that the new test kit may be helpful in detecting patients with immediate type allergy to beta-lactams. Without this test, in those three patients reacting exclusively to MDM, and oral provocation test would have been necessary to clarify their allergy. Data from larger groups of patients are needed to determine the sensitivity and specificity of this test kit.
Treudler
Regina
R
Department of Dermatology, Venereology and Allergy, Universitätsklinikum Leipzig A. ö. R., Germany. regina.treudler@uniklinik-leipzig.de
Simon
Jan Christoph
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012882:Skin Tests / Q000295:instrumentation* / Q000379:methods*; D047090:beta-Lactams / Q000009:adverse effects* / Q000276:immunology
D000900:Anti-Bacterial Agents; D011933:Reagent Kits, Diagnostic; D047090:beta-Lactams