Serum specific IgE antibodies in immediate drug hypersensitivity.

Immediate drug hypersensitivity reactions (IDHRs) constitute a significant health problem that may be compounded by consequences of diagnostic error. In daily practice, IDHR diagnostic work up starts with drug-specific skin testing and/or quantification of specific IgE (sigE) antibodies in serum. Here we critically review the performance, i.e. potential and limitations of sIgE to β-lactam antibiotics (β-LABs), curarizing neuromuscular blocking agents (NMBAs), opiates and (semi)synthetic opioids, fluoroquinolones (FQs), poppy seed (papaver somniferum), chlorhexidine and finally Hevea latex. Quintessence of these studies is clear. Quantification of these drug-specific sIgE should not be used in isolation to document or exclude diagnosis of an IDHR. False negative results entail the risk for subsequent potentially life-threatening anaphylaxis upon re-exposure. False positive results lead to erroneous avoidance and unnecessary substitutions and fails to identify the true etiology.

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Copyright © 2020. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.