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The risk of first-degree relatives developing the same hypersensitivity reaction is higher than in the general population. [1] As this syndrome can present secondary to multiple anticonvulsants, the general term "anticonvulsant hypersensitivity syndrome" (AHS) is favored over the original descriptive term "dilantin hypersensitivity syndrome."
Identifying an allergy to penicillin requires a hypersensitivity skin test, which diagnoses IgE-mediated immune responses caused by penicillin. This test is typically performed by an allergist who uses a skin-prick and intradermal injection of penicilloyl-polylysine, a negative control (normal saline), and a positive control ( histamine ).
Reactive arthritis, previously known as Reiter's syndrome, [1] is a form of inflammatory arthritis [2] that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. [ 3 ]
It is possible, however, that those allergic symptoms are not because of an allergy to the medication, but more an immune reaction to the infection being treated, Risma said.
Cross-reactivity, in a general sense, is the reactivity of an observed agent which initiates reactions outside the main reaction expected. This has implications for any kind of test or assay , including diagnostic tests in medicine, and can be a cause of false positives .
Additionally, those with penicillin allergies can usually tolerate cephalosporins (another group of β-lactam) because the immunoglobulin E (IgE) cross-reactivity is only 3%. [5] Penicillin was discovered in 1928 by Scottish scientist Alexander Fleming as a crude extract of P. rubens. [6]
Penicillin-sensitive patients may also be allergic to the cephalosporins, depending on the side chain and it's relation to the penicillin allergy. Most patients with penicillin allergy can tolerate the majority of cephalosporins without allergic reactions. The previous percentage of 10% cross reactivity rates are a gross overestimation. [7]
Cross-allergic reactions occur among the β-lactam antibiotics. To determine whether treatment with a β-lactam is safe when an allergy is noted, patient history regarding severity of previous reaction is essential. [1]
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