Kirkpatrick C H
Conrad D. Stephenson Laboratory for Research in Immunology, Denver, CO.
Am J Emerg Med. 1991 Mar;9(2 Suppl 1):7-10; discussion 33-4. doi: 10.1016/0735-6757(91)90160-l.
Seven hundred seventeen adult patients with life-threatening digitalis intoxication were treated with Fab fragments of ovine antidigoxin immunoglobulin G (IgG). Results of the efficacy of treatment and adverse effects were collected with standard report forms. Eighty-two (11%) of the patients were recorded as having histories of allergy (71 patients) and/or asthma (11 patients). Of the "allergic" subjects, 35 described reactions to antibiotics, 19 to other medications, 3 to foods, and 2 to pollens; in 12 subjects the etiologic agent was not specified. Six subjects had adverse reactions that were probably or possibly due to allergy to components of the antibody preparation. Of these 4 (5%; 95% confidence interval (Cl) 1.8% to 12%) occurred in the 82 subjects with histories of allergy or asthma and 3 (9%; 95% Cl 1.8% to 23%) of these occurred in the 35 persons with histories of allergy to an antibiotic. In contrast, only 2 (0.3%; 95% Cl 0.04% to 1.1%) similar reactions occurred in the 635 subjects with no histories of allergy or asthma. All reactions responded to symptomatic treatment. The authors conclude that treatment of digitalis intoxication with ovine antidigoxin IgG-Fab (Digibind) is generally well tolerated and allergic reactions are rare. However, there is a significantly increased risk of reactions in patients with histories of allergy or asthma.
717例患有危及生命的洋地黄中毒的成年患者接受了羊抗地高辛免疫球蛋白G（IgG）的Fab片段治疗。使用标准报告表格收集治疗效果和不良反应的结果。82例（11%）患者有过敏史（71例）和/或哮喘史（11例）。在这些“过敏”患者中，35例描述了对抗生素的反应，19例对其他药物的反应，3例对食物的反应，2例对花粉的反应；12例患者未明确病因。6例患者的不良反应可能或可能是由于对抗体制剂成分过敏所致。其中4例（5%；95%置信区间（Cl）1.8%至12%）发生在有过敏或哮喘史的82例患者中，其中3例（9%；95%Cl 1.8%至23%）发生在有抗生素过敏史的35例患者中。相比之下，在635例无过敏或哮喘史的患者中，仅发生2例（0.3%；95%Cl 0.04%至1.1%）类似反应。所有反应均对对症治疗有反应。作者得出结论，用羊抗地高辛IgG-Fab（地高辛抗体）治疗洋地黄中毒通常耐受性良好，过敏反应罕见。然而，有过敏或哮喘史的患者发生反应的风险显著增加。
