Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
J Korean Med Sci. 2011 May;26(5):682-5. doi: 10.3346/jkms.2011.26.5.682. Epub 2011 Apr 21.
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.
这是首例报告的职业暴露后发生过敏反应的患者血清 IgE 抗体对哌拉西林-人血清白蛋白（HSA）结合物的检测。一名 24 岁的护士，在大学医院工作了 2 年，在注射哌拉西林后 10 分钟出现胸闷、头晕、全身性荨麻疹、腹痛和腹泻。她之前患有特应性皮炎。对常见吸入性过敏原的皮肤点刺试验完全为阴性；相比之下，她的血清总 IgE 升高（283 IU/mL）。通过使用哌拉西林-HSA 结合物的 ELISA 检测到哌拉西林特异性血清 IgE 水平升高。抑制 ELISA 检测到添加游离哌拉西林和哌拉西林-HSA 结合物均有显著抑制作用。这些数据表明，工作场所接触哌拉西林可诱发由 IgE 与哌拉西林半抗原相互作用介导的职业性过敏反应和荨麻疹。
