Immunologic evaluation of patients with cefotetan-induced anaphylaxis.
Cefotetan is a commonly prescribed second-generation cephalosporin that acts against a wide range of bacteria. However, cefotetan-induced hypersensitivity has rarely been reported. We report 2 cases of cefotetan-induced anaphylaxis with immunologic evaluation. The first case was a 70-year-old asthmatic woman who had dyspnea and hypotension during administration of cefotetan, in which high serum-specific IgE to cefotetan-human serum albumin (HSA) conjugate was detected by enzyme-linked immunosorbent assay. The second case was a 63-year-old asthmatic woman who complained of chest tightness and dyspnea during cefotetan infusion, in which high serum-specific IgG1 and IgG4 with no serum specific IgE to cefotetan-HSA conjugate was detected. The basophil activation test using basophils from the patient showed a significant up-regulation of CD63 with the addition of anti-IgG4 antibody compared with that in non-atopic healthy controls. In conclusion, cefotetan can induce anaphylaxis, which may involve both IgE- and IgG4-mediated responses in the pathogenic mechanism.
Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
Young Hee
YH
Nam
Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Eui Kyung
EK
Hwang
Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Ga Young
GY
Ban
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Hyun Jung
HJ
Jin
Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Hye Soo
HS
Yoo
Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Yoo Seob
YS
Shin
Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Young Min
YM
Ye
Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Dong Ho
DH
Nahm
Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Hae Sim
http://orcid.org/0000-0003-2614-0303
HS
Park
Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea. skleeai@dau.ac.kr.
Soo Keol
SK
Lee
Anaphylaxis; cefotetan; specific IgE; specific IgG4