Kraft D, Roth A, Mischer P, Pichler H, Ebner H
Clin Allergy. 1977 Jan;7(1):21-8. doi: 10.1111/j.1365-2222.1977.tb01420.x.
Sera from 204 patients with acute or former reactions following penicillin treatment were investigated by RAST with specificity for benzylpenicilloyl and phenoxymethyl-penicilloyl. The IgE antibody levels were followed up for of more than 2 years. Positive results could be observed at the time of the acute reactions and the weeks following; later months or years in many cases. Occasionally negative RAST results occurred within 30 days; on the other hand high levels of specific IgE persisted for years in some patients. Total serum IgE measured by RIST and the RAST results showed similar patterns, with mean levels of 568 u/ml between 0 and 30 days after the penicillin allergic reaction, 286 u/ml between 30 days and 1 year, and 195 u/ml in cases after 1 year corresponded well with the observed decline in specific IgE. Skin tests performed with penicilloyl-polylysine in 118 patients showed an overall correlation of 91-5% with the RAST results. Differences between the two test systems were observed in patients with a long interval between the test and the last allergic attack. None of the patients with proved penicillin allergy had atopic diseases or a history of atopy. On the basis of these findings it is suggested that the determination of both circulating specific IgE and total IgE should be of great value for diagnostic purposes during acute drug reactions and in the months immediately afterwards.
采用对苄青霉素酰和苯氧甲基青霉素酰具有特异性的放射变应原吸附试验（RAST），对204例青霉素治疗后出现急性或既往反应的患者血清进行了研究。对IgE抗体水平进行了两年多的随访。在急性反应时及随后几周可观察到阳性结果；在许多情况下，数月或数年之后仍为阳性。偶尔在30天内会出现RAST阴性结果；另一方面，一些患者的特异性IgE高水平会持续数年。用放射免疫吸附试验（RIST）测定的总血清IgE和RAST结果显示出相似的模式，青霉素过敏反应后0至30天的平均水平为568 u/ml，30天至1年为286 u/ml，1年后为195 u/ml，这与观察到的特异性IgE下降情况相符。对118例患者用青霉素酰多聚赖氨酸进行的皮肤试验与RAST结果的总体相关性为91.5%。在试验与最后一次过敏发作间隔时间较长的患者中，观察到了两种检测系统之间的差异。所有已证实对青霉素过敏的患者均无特应性疾病或特应性病史。基于这些发现，建议在急性药物反应期间及之后的几个月内，测定循环特异性IgE和总IgE对诊断具有重要价值。
