title: A case of piperacillin-induced occupational anaphylaxis: detection of serum IgE to piperacillin-HSA conjugate.
abstract: This is the first reported detection of serum IgE antibody to piperacillin-human serum albumin (HSA) conjugate in a patient presenting with anaphylaxis that developed after occupational exposure. A 24-yr-old nurse, who had worked at a University Hospital for 2 yr, experienced chest tightness, dizziness, generalized urticaria, abdominal pain, and diarrhea 10 min after administering a piperacillin injection. She had previously suffered from atopic dermatitis. A skin prick test for common inhalant allergens was entirely negative; in contrast, her serum total IgE was elevated (283 IU/mL). A high level of piperacillin-specific serum IgE was detected by ELISA using piperacillin-HSA conjugate. Significant inhibition upon addition of both free piperacillin and piperacillin-HSA conjugate was detected by inhibition ELISA. These data suggest that piperacillin exposure in the workplace can induce occupational anaphylaxis and urticaria mediated by an interaction of IgE with the hapten of piperacillin.
authors.affiliation: Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jeong-Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Seung-Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Joo-Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: Joon-Woo
authors.initials: JW
authors.lastname: Bahn
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Jin
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Ye
authors.forename: Hae-Sim
authors.initials: HS
authors.lastname: Park
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D007362:Intensive Care Units; D009784:Occupational Diseases / Q000139:chemically induced* / Q000276:immunology; D016273:Occupational Exposure; D010878:Piperacillin / Q000276:immunology*; D012709:Serum Albumin / Q000276:immunology*; D014581:Urticaria / Q000276:immunology; D055815:Young Adult
chemical_list: D012709:Serum Albumin; D007073:Immunoglobulin E; D010878:Piperacillin