Naclerio R, Mizrahi E A, Adkinson N F
J Allergy Clin Immunol. 1983 Mar;71(3):294-301. doi: 10.1016/0091-6749(83)90083-0.
A nurse anesthetist who had experienced four systemic allergic reactions attributed to penicillin exposure was safely and successfully desensitized to penicillin despite predominantly minor determinant allergy (benzyl penicilloate skin test was positive at 1:100,000 dilution of standard 10 mM solution). Because of unavoidable occupational exposure to penicillin, daily oral doses of penicillin were continued after hospital discharge in an effort to maintain clinical tolerance. Immunologic measurements throughout the long-term desensitization effort provided some evidence that in this patient, drug-induced mast cell desensitization is an ongoing dynamic process that is dose dependent and that skin mast cell reactivity recovers slowly over a period of many weeks after the short-term high-dose desensitization protocol. A dose-dependent state of clinical tolerance to inadvertent penicillin exposure has been safely maintained in this patient for 18 mo.
一名曾因接触青霉素经历过4次全身过敏反应的麻醉护士，尽管主要是次要决定簇过敏（在标准10 mM溶液1:100,000稀释度下苄青霉素皮肤试验呈阳性），但仍安全且成功地对青霉素进行了脱敏治疗。由于不可避免的职业性青霉素接触，出院后继续每日口服青霉素剂量，以维持临床耐受性。在长期脱敏过程中的免疫学测量提供了一些证据，表明在该患者中，药物诱导的肥大细胞脱敏是一个持续的动态过程，且具有剂量依赖性，并且在短期高剂量脱敏方案后，皮肤肥大细胞反应性在数周内缓慢恢复。该患者已安全维持对意外接触青霉素的剂量依赖性临床耐受性达18个月。
