Basomba A, Peláez A, Villalmanzo I G, Campos A
Clin Allergy. 1978 Jul;8(4):341-5. doi: 10.1111/j.1365-2222.1978.tb00469.x.
In a patient with a past history of allergy to penicillin and requiring treatment, skin tests with penicillin and penicilloyl-polylysine (PPL) were positive, and a penicilloyl RAST was strongly positive, although the Prausnitz-Küstner test to penicillin and PPL were negative. The haptin BPO-Flys was administered together with penicillin to try to prevent reactions. An anaphylactic reaction occurred on the fifth day, and treatment was stopped. Serum total IgE values increased markedly after the reaction and PK titres to penicillin and PPL reached values of 1/256. The skin test reaction to PPL was negative the day after the clinical reaction, but became strongly positive again a few days later. The penicilloyl RAST remained strongly positive throughout. The authors consider that there was hypersensitivity to a penicillin metabolite other than the penicilloyl group, e.g. to minor determinants, and for this reason the hapten inhibitor failed.
在一名有青霉素过敏史且需要治疗的患者中，青霉素和青霉噻唑酰聚赖氨酸（PPL）皮肤试验呈阳性，青霉素半抗原放射变应原吸附试验（RAST）呈强阳性，尽管对青霉素和PPL的普劳斯尼茨－屈斯特纳试验（Prausnitz-Küstner test）呈阴性。将半抗原BPO-聚赖氨酸与青霉素一起给药以试图预防反应。在第五天发生了过敏反应，于是停止治疗。反应后血清总IgE值显著升高，对青霉素和PPL的PK滴度达到1/256。临床反应后第二天对PPL的皮肤试验反应为阴性，但几天后又再次变为强阳性。青霉素半抗原RAST始终保持强阳性。作者认为，患者对除青霉噻唑基团以外的青霉素代谢产物过敏，例如对次要决定簇过敏，因此半抗原抑制剂未能发挥作用。
