title: Selective hypersensitivity to cefazolin and contribution of the basophil activation test.
abstract: The authors present 2 case reports of selective cefazolin hypersensitivity: a 49 year-old woman with a history of two perioperative reactions (urticaria and severe anaphylaxis) after the use of rocuronium, propophol and cefazolin; a 36 year-old pregnant woman who developed facial erythema, lips angioedema and hypotension immediately after administration of ropivacain, sufentanil, cefazolin, oxytocin and ephedrine. In both cases, intradermal skin tests were positive for cefazolin. A basophil activation test was performed for cefazolin, which was positive in one patient. Oral challenge tests with penicillin, amoxicillin and other cephalosporins were negative. This selective hypersensitivity to cefazolin may be associated with a R1-side chain different from other beta-lactams.
authors.affiliation: Department of Immunoallergology, Santa Maria Hospital, Lisbon, Portugal Unit of Clinical Immunology, Institute of Molecular Medicine, Faculty of Medicine of Lisbon, Portugal. E-mail: jpedro.gla@gmail.com.
authors.forename: J P
authors.initials: JP
authors.lastname: Almeida
authors.affiliation: Department of Immunoallergology, Santa Maria Hospital, Lisbon, Portugal Unit of Clinical Immunology, Institute of Molecular Medicine, Faculty of Medicine of Lisbon, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Lopes
authors.affiliation: Department of Immunoallergology, Santa Maria Hospital, Lisbon, Portugal Unit of Clinical Immunology, Institute of Molecular Medicine, Faculty of Medicine of Lisbon, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Campos Melo
authors.affiliation: Department of Immunoallergology, Santa Maria Hospital, Lisbon, Portugal Unit of Clinical Immunology, Institute of Molecular Medicine, Faculty of Medicine of Lisbon, Portugal.
authors.forename: M C
authors.initials: MC
authors.lastname: Pereira Santos
authors.affiliation: Department of Immunoallergology, Santa Maria Hospital, Lisbon, Portugal Unit of Clinical Immunology, Institute of Molecular Medicine, Faculty of Medicine of Lisbon, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Pereira Barbosa
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000276:immunology; D015549:Basophil Degranulation Test; D001491:Basophils / Q000187:drug effects* / Q000276:immunology; D002437:Cefazolin / Q000009:adverse effects* / Q000276:immunology; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D005260:Female; D006801:Humans; D007428:Intradermal Tests; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D014581:Urticaria / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin
keywords: R1 side chain; basophil activation test; cefazolin; selective hypersensitivity