Cefotiam‐induced IgE‐mediated occupational contact anaphylaxis of nurses; case reports, RAST analysis, and a review of the literature
Identifieur interne : 000D65 ( Istex/Corpus ); précédent : 000D64; suivant : 000D66Cefotiam‐induced IgE‐mediated occupational contact anaphylaxis of nurses; case reports, RAST analysis, and a review of the literature
Auteurs : K. Tadokoro ; N. Niimi ; T. Ohtoshi ; K. Nakajima ; S. Takafuji ; K. Onodera ; S. Suzuki ; M. MuranakaSource :
- Clinical & Experimental Allergy [ 0954-7894 ] ; 1994-02.
Abstract
Cefotiam (CTM) is one of the most popular cephem antibiotics in Japan. Recently we experienced two cases of nurses with CTM‐induced contact anaphylaxis. When they were preparing drip infusions of antibiotics or working around other nurses doing so, they suddenly fell into shock with other symptoms such as flushing, urtiearia, abdominal distress, vomiting, dyspnoea and or loss of consciousness. The symptoms never occurred after they avoided exposure to CTM. Passive cutaneous or open patch tests were positive for CTM. Histamine release was induced by CTM from washed leucocytes. RAST analysis using CTM‐human serum albumin‐coupled dises showed high % RAST count, suggesting that these reactions were mediated by IgE antibodies. A RAST inhibition test suggested that the methyl‐thiotetrazol side‐chain was the main antigenic determinant. Both patients had hand dermatitis that had appeared preceding the episodes of anaphylaxis. Although the dermatitis had been resistant to treatments, it also disappeared after they avoided exposure to CTM, It seemed likely that it was also induced or exacerbated by CTM and facilitated the penetration of CTM to cause anaphylaxis. The literature is also reviewed.
Url:
DOI: 10.1111/j.1365-2222.1994.tb00208.x
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<front><div type="abstract" xml:lang="en">Cefotiam (CTM) is one of the most popular cephem antibiotics in Japan. Recently we experienced two cases of nurses with CTM‐induced contact anaphylaxis. When they were preparing drip infusions of antibiotics or working around other nurses doing so, they suddenly fell into shock with other symptoms such as flushing, urtiearia, abdominal distress, vomiting, dyspnoea and or loss of consciousness. The symptoms never occurred after they avoided exposure to CTM. Passive cutaneous or open patch tests were positive for CTM. Histamine release was induced by CTM from washed leucocytes. RAST analysis using CTM‐human serum albumin‐coupled dises showed high % RAST count, suggesting that these reactions were mediated by IgE antibodies. A RAST inhibition test suggested that the methyl‐thiotetrazol side‐chain was the main antigenic determinant. Both patients had hand dermatitis that had appeared preceding the episodes of anaphylaxis. Although the dermatitis had been resistant to treatments, it also disappeared after they avoided exposure to CTM, It seemed likely that it was also induced or exacerbated by CTM and facilitated the penetration of CTM to cause anaphylaxis. The literature is also reviewed.</div>
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<p>Cefotiam (CTM) is one of the most popular cephem antibiotics in Japan. Recently we experienced two cases of nurses with CTM‐induced contact anaphylaxis. When they were preparing drip infusions of antibiotics or working around other nurses doing so, they suddenly fell into shock with other symptoms such as flushing, urtiearia, abdominal distress, vomiting, dyspnoea and or loss of consciousness. The symptoms never occurred after they avoided exposure to CTM. Passive cutaneous or open patch tests were positive for CTM. Histamine release was induced by CTM from washed leucocytes. RAST analysis using CTM‐human serum albumin‐coupled dises showed high % RAST count, suggesting that these reactions were mediated by IgE antibodies. A RAST inhibition test suggested that the methyl‐thiotetrazol side‐chain was the main antigenic determinant. Both patients had hand dermatitis that had appeared preceding the episodes of anaphylaxis. Although the dermatitis had been resistant to treatments, it also disappeared after they avoided exposure to CTM, It seemed likely that it was also induced or exacerbated by CTM and facilitated the penetration of CTM to cause anaphylaxis. The literature is also reviewed.</p>
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<mods version="3.6"><titleInfo lang="en"><title>Cefotiam‐induced IgE‐mediated occupational contact anaphylaxis of nurses; case reports, RAST analysis, and a review of the literature</title>
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<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Cefotiam‐induced IgE‐mediated occupational contact anaphylaxis of nurses; case reports, RAST analysis, and a review of the literature</title>
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<name type="personal"><namePart type="given">K.</namePart>
<namePart type="family">TADOKORO</namePart>
<affiliation>Department of Research, The Japanese Red Cross Central Blood Centre, Tokyo, Japan</affiliation>
<description>Correspondence: Dr K. Tadokoro, Department of Research, The Japanese Red Cross Central Blood Center, 4‐1‐31, Hiro‐o. Shibuya‐ku, Tokyo, 150 Japan</description>
<role><roleTerm type="text">author</roleTerm>
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</name>
<name type="personal"><namePart type="given">N.</namePart>
<namePart type="family">NIIMI</namePart>
<affiliation>Yuaikinen Hospital, Ibaraki, Japan</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">T.</namePart>
<namePart type="family">OHTOSHI</namePart>
<affiliation>Department of Medicine and Physical Therapy, Faculty of Medicine, University of Tokyo, Tokyo, Japan</affiliation>
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<name type="personal"><namePart type="given">K.</namePart>
<namePart type="family">NAKAJIMA</namePart>
<affiliation>Department of Medicine and Physical Therapy, Faculty of Medicine, University of Tokyo, Tokyo, Japan</affiliation>
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<name type="personal"><namePart type="given">S.</namePart>
<namePart type="family">TAKAFUJI</namePart>
<affiliation>Department of Medicine and Physical Therapy, Faculty of Medicine, University of Tokyo, Tokyo, Japan</affiliation>
<role><roleTerm type="text">author</roleTerm>
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</name>
<name type="personal"><namePart type="given">K.</namePart>
<namePart type="family">ONODERA</namePart>
<affiliation>Department of Medicine and Physical Therapy, Faculty of Medicine, University of Tokyo, Tokyo, Japan</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">S.</namePart>
<namePart type="family">SUZUKI</namePart>
<affiliation>Health Care Center, University of Shijuoka, Shizuoka, Japan</affiliation>
<role><roleTerm type="text">author</roleTerm>
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</name>
<name type="personal"><namePart type="given">M.</namePart>
<namePart type="family">MURANAKA</namePart>
<affiliation>Yugawara Kosei‐nenkin Hospital, Kanagawa, Japan</affiliation>
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<originInfo><publisher>Blackwell Publishing Ltd</publisher>
<place><placeTerm type="text">Oxford, UK</placeTerm>
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<dateIssued encoding="w3cdtf">1994-02</dateIssued>
<edition>Submitted 26 January 1993; revised 20 August 1993: accepted 13 September 1993.</edition>
<copyrightDate encoding="w3cdtf">1994</copyrightDate>
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<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
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<abstract lang="en">Cefotiam (CTM) is one of the most popular cephem antibiotics in Japan. Recently we experienced two cases of nurses with CTM‐induced contact anaphylaxis. When they were preparing drip infusions of antibiotics or working around other nurses doing so, they suddenly fell into shock with other symptoms such as flushing, urtiearia, abdominal distress, vomiting, dyspnoea and or loss of consciousness. The symptoms never occurred after they avoided exposure to CTM. Passive cutaneous or open patch tests were positive for CTM. Histamine release was induced by CTM from washed leucocytes. RAST analysis using CTM‐human serum albumin‐coupled dises showed high % RAST count, suggesting that these reactions were mediated by IgE antibodies. A RAST inhibition test suggested that the methyl‐thiotetrazol side‐chain was the main antigenic determinant. Both patients had hand dermatitis that had appeared preceding the episodes of anaphylaxis. Although the dermatitis had been resistant to treatments, it also disappeared after they avoided exposure to CTM, It seemed likely that it was also induced or exacerbated by CTM and facilitated the penetration of CTM to cause anaphylaxis. The literature is also reviewed.</abstract>
<relatedItem type="host"><titleInfo><title>Clinical & Experimental Allergy</title>
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<genre type="Journal">journal</genre>
<identifier type="ISSN">0954-7894</identifier>
<identifier type="eISSN">1365-2222</identifier>
<identifier type="DOI">10.1111/(ISSN)1365-2222</identifier>
<identifier type="PublisherID">CEA</identifier>
<part><date>1994</date>
<detail type="volume"><caption>vol.</caption>
<number>24</number>
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<detail type="issue"><caption>no.</caption>
<number>2</number>
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<extent unit="pages"><start>127</start>
<end>133</end>
<total>7</total>
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<identifier type="DOI">10.1111/j.1365-2222.1994.tb00208.x</identifier>
<identifier type="ArticleID">CEA127</identifier>
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