Detection of Serum IgE Antibodies that React with Alcuronium and Tubocurarine after Lifethreatening Reactions to Muscle-relaxant Drugs

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Abstract
Although anaphylactoid reactions to muscle-relaxant drugs are now well recognised, there has been no general agreement on the mechanism(s) underlying the responses. By covalently coupling alcuronium and tubocurarine to a solid phase carrier and using the resultant complexes in radioimmunoassay experiments with patients’ sera and 125I-anti-human IgE, we have found high levels of drug-specific IgE antibodies in the sera of some subjects who reacted to these muscle relaxants. These results provide important supporting evidence that, in some patients at least, lifethreatening anaphylactoid reactions to muscle-relaxant drugs are mediated by drug-specific IgE antibodies.

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