Kraft D, Wide L
Br J Dermatol. 1976 Jun;94(6):593-601. doi: 10.1111/j.1365-2133.1976.tb05156.x.
Seventy-nine patients with acute or former reactions to penicillin were investigated by a benzylpenicilloyl (BPO)-specific RAST and/or by skin tests with penicilloyl-polylysine (PPL), benzylpenicillin and penicilloic acid and the results were correlated with the different clinical pictures. Positive RAST and skin test results could be found in patients with anaphylactic shock, urticaria and serum sickness-like reaction and sometimes in a special group of exanthems, which are characterized by the existence of many different lesions at the same time, therefore called 'polymorphic exanthems', and often observed after high-dosage penicillin therapy. In cases of scarlatiniform or morbilliform exanthems no positive results were found. The BPO-specific RAST showed an overall correlation of 95-I% with skin tests using PPL. However, some patients with positive skin tests to benzylpenicillin and penicilloic acid did no have detectable circulating IgE antibodies to BPO. This emphasizes the need for including these antigens in in vitro methods. The RAST was informative even at the allergic reaction or in the first 15 days afterwards and seems to be very valuable for early diagnosis of penicillin allergy especially in cases when many drugs have been given.
对79例有青霉素急性或既往反应的患者进行了苄青霉素酰（BPO）特异性放射变应原吸附试验（RAST）和/或用青霉素酰聚赖氨酸（PPL）、苄青霉素和青霉酸进行皮肤试验，并将结果与不同的临床表现进行了关联。在过敏性休克、荨麻疹和血清病样反应患者中，有时在一组特殊的皮疹患者中可发现RAST和皮肤试验结果呈阳性，这组皮疹的特征是同时存在许多不同的损害，因此称为“多形性皮疹”，且常在大剂量青霉素治疗后观察到。在猩红热样或麻疹样皮疹病例中未发现阳性结果。BPO特异性RAST与使用PPL的皮肤试验总体相关性为95 - 1%。然而，一些对苄青霉素和青霉酸皮肤试验呈阳性的患者并未检测到循环中的BPO特异性IgE抗体。这强调了在体外检测方法中纳入这些抗原的必要性。即使在过敏反应期间或之后的前15天，RAST也具有参考价值，并且对于青霉素过敏的早期诊断似乎非常有价值，尤其是在使用了多种药物的情况下。
