Determinations of Penicilloyl Specific IgE Antibodies for the Evaluation of Hypersensitivity against Penicillin

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Abstract
Results from skin tests and radioallergosorbent test (penicilloyl G and penicilloyl V) were compared in 76 patients with suspected penicillin hypersensitivity and in 22 control subjects without such clinical symptoms. The test results were also correlated to the clinical history of adverse reactions and to the levels of total serum IgE. The overall agreement between skin test and R.AST results was 89% in the patient group. Two of the control subjects without symptoms were professionally employed with penicillin production; one of them had circulating IgE‐antibodies and the other exhibited positive skin tests. The skin tests were more frequently positive than the RAST test. By means of skin titration some of the skin tests were demonstrated to be false positive. The discrepancy can also be explained by the fact that skin reactions also occur in other situations than IgE‐mediated adverse reactions. Circulating IgE‐antibodies were not found in any of 23 cases where adverse reactions appeared later than 24 h after the latest penicillin administration.It is concluded that the measurement of circulating IgE‐antibodies is a valuable aid in the diagnosis of penicillin allergy.