Bousquet P J, Kvedariene V, Co-Minh H-B, Martins P, Rongier M, Arnoux B, Demoly P
Exploration des Allergies, Service des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier; INSERM U454-IFR3, Hôpital Arnaud de Villeneuve, Montpellier, France.
Allergy. 2007 Aug;62(8):872-6. doi: 10.1111/j.1398-9995.2007.01463.x.
beta-lactam hypersensitivity reactions are classified as immediate or nonimmediate. Diagnosis is usually based upon skin tests and provocation challenges.
The time course of the reactions in proven beta-lactam hypersensitivities was studied and then correlated with the symptoms to determine the relationship between the clinical presentations and the time course.
All of the patients who consulted between 1996 and 2004 for a suspected beta-lactam hypersensitivity reaction were studied. Two hundred and ten patients with a proven hypersensitivity reaction diagnosed according to the European Network on Drug Allergy were included in the present study.
Of the patients, 36.7% had urticaria as a single symptom, 19.1% anaphylaxis without shock, 17.6% anaphylactic shock and 19.1% maculopapular exanthema. Anaphylactic shock and anaphylaxis mostly occurred within 1 h after drug administration. Exanthema mainly occurred after 24 h. Urticaria as a single symptom occurred at any time. A firm diagnosis was determined using immediate-reading skin prick (10.0%) and intradermal tests (38.1%), late-reading skin tests (19.1%) or provocation tests (32.9%).
Depending on the time course of the reaction, three clinical groups were identified: anaphylaxis and anaphylactic shock (immediate reaction); maculopapular exanthema (late reaction) as well as urticaria (immediate and late reaction).
β-内酰胺类过敏反应分为速发型和非速发型。诊断通常基于皮肤试验和激发试验。
研究已证实的β-内酰胺类过敏反应的反应时间进程，然后将其与症状相关联，以确定临床表现与时间进程之间的关系。
对1996年至2004年间因疑似β-内酰胺类过敏反应前来咨询的所有患者进行研究。本研究纳入了210例根据欧洲药物过敏网络诊断为已证实过敏反应的患者。
患者中，36.7%以荨麻疹为单一症状，19.1%为无休克的过敏反应，17.6%为过敏性休克，19.1%为斑丘疹。过敏性休克和过敏反应大多在给药后1小时内发生。皮疹主要在24小时后出现。单一症状的荨麻疹可在任何时间发生。通过即时读数皮肤点刺试验（10.0%）、皮内试验（38.1%）、延迟读数皮肤试验（19.1%）或激发试验（32.9%）确定明确诊断。
根据反应的时间进程，确定了三个临床组：过敏反应和过敏性休克（速发反应）；斑丘疹（迟发反应）以及荨麻疹（速发和迟发反应）。
