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New Test for Penicillin Allergy: Title and subTitle BreakFluorometric Assay of Histamine Release FREE

Walter B. Shelley, MD; J. Stanley Comaish, MB, MRCP
[+] Author Affiliations

Reprint requests to 3400 Spruce St, Philadelphia 19104 (Dr. Shelley).


From the Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia.


JAMA. 1965;192(1):36-40. doi:10.1001/jama.1965.03080140042010
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Therese days to recite the frequency and dangers of penicillin-induced allergic reactions. Suffice to say that penicillin has overtaken animal sera as the major cause of anaphylaxis in this country,1 while thousands are denied its antibacterial benefits because of previous adverse reactions.

There have been many and varied attempts to devise a reliable way of detecting the development of such allergy in the individual patient. None of these attempts has proved completely satisfactory so far. Skin and ophthalmic tests with penicillin are known to be not only inaccurate but dangerous on occasion; several cases of anaphylaxis and even one fatality have been reported in the literature.2 Hemagglutination titers too often seem merely to indicate previous penicillin administration, and bear little relation to previous or subsequent allergic reactions, though recently deWeck3 has obtained more promising results. Intradermal testing with penicilloyl-poly lysine4 has been a useful advance, although

REFERENCES

Kern, R.A., and Wimberly, N.A.:  Penicillin Reactions: Their Nature, Growing Importance, Recognition, Management and Prevention , Amer J Med Sci 226:357-375 ( (Oct) ) 1953;.
Rose, B.. in Boger, W.P., et al:  Allergic Reactions to Penicillin, panel discussion , J Allerg 24:383-404 ( (Sept) ) 1953;.
deWeck, A.L.:  Penicillin Allergy: Its Detection by Improved Haemagglutination Technique , Nature 202:975-977 ( (June 6) ) 1964;.
Parker, C.W., et al:  Hypersensitivity to Penicillenic Acid Derivatives in Human Beings With Penicillin Allergy , J Exp Med 115:821-838 ( (April 1) ) 1962;.
Brown, B.C.: Price, E.V.; and Moore, M.B.:  Penicilloyl-Polylysine as Intradermal Test of Penicillin Sensitivity , JAMA 189: 599-604 ( (Aug 24) ) 1964;.
Urbach, E., and Gottlieb. P.M.: Allergy , New York: Grune & Stratton, 1943;.
Martinez Cortes, F., and Nava Hernandez, U.:  Alergia a la Penicilina Nuevo metodo diagnostico , Prensa Med Mex 27:299-302 ( (July) -Aug) 1962;.
Layton, L.L., et al:  Atopic Reagins to Penicillin, Pollens and Seeds: Thermolability, Titre and Persistence in Skin of Passively Sensitized Macaque Monkeys , Int Arch Allerg 23:87-89, 1963;.
Shelley, W.B.:  Indirect Basophil Degranulation Test for Allergy to Penicillin and Other Drugs , JAMA 184:171-178 ( (April 20) ) 1963;.
Noah, J.W., and Brand, A.:  Simplified Micromethod for Measuring Histamine in Human Plama , J Lab Clin Med 62:506-510 ( (Sept) ) 1963;.
Van Arsdel, P.P., and Sells, C.J.:  Antigenic Histamine Release From Passively Sensitized Human Leucocytes , Science 141: 1190-1191 ( (Sept 20) ) 1963;.
Noah, J.W.: " Anaphylactic Histamine Release and Schultz-Dale Reaction ," in Ackroyd, J.F. (ed.): Immunological Methods , Philadelphia: F.A. Davis Co., 1964;.
Shelley, W.B.:  Circulating Basophil as Indicator of Hyper-Sensitivity in Man: Experimental Novobiocin Sensitization , Arch Derm 88:759-767 ( (Dec) ) 1963;.
Uri, J.; Valu, G.; and Bekesi, I.:  Production of 6-Amino-Penicillanic Acid by Dermatophytes , Nature 200:896-897 ( (Nov 30) ) 1963;.
Udenfriend, S.: Fluorescence Assay in Biology and Medicine , New York: Academic Press, 1962;.

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Kern, R.A., and Wimberly, N.A.:  Penicillin Reactions: Their Nature, Growing Importance, Recognition, Management and Prevention , Amer J Med Sci 226:357-375 ( (Oct) ) 1953;.
Rose, B.. in Boger, W.P., et al:  Allergic Reactions to Penicillin, panel discussion , J Allerg 24:383-404 ( (Sept) ) 1953;.
deWeck, A.L.:  Penicillin Allergy: Its Detection by Improved Haemagglutination Technique , Nature 202:975-977 ( (June 6) ) 1964;.
Parker, C.W., et al:  Hypersensitivity to Penicillenic Acid Derivatives in Human Beings With Penicillin Allergy , J Exp Med 115:821-838 ( (April 1) ) 1962;.
Brown, B.C.: Price, E.V.; and Moore, M.B.:  Penicilloyl-Polylysine as Intradermal Test of Penicillin Sensitivity , JAMA 189: 599-604 ( (Aug 24) ) 1964;.
Urbach, E., and Gottlieb. P.M.: Allergy , New York: Grune & Stratton, 1943;.
Martinez Cortes, F., and Nava Hernandez, U.:  Alergia a la Penicilina Nuevo metodo diagnostico , Prensa Med Mex 27:299-302 ( (July) -Aug) 1962;.
Layton, L.L., et al:  Atopic Reagins to Penicillin, Pollens and Seeds: Thermolability, Titre and Persistence in Skin of Passively Sensitized Macaque Monkeys , Int Arch Allerg 23:87-89, 1963;.
Shelley, W.B.:  Indirect Basophil Degranulation Test for Allergy to Penicillin and Other Drugs , JAMA 184:171-178 ( (April 20) ) 1963;.
Noah, J.W., and Brand, A.:  Simplified Micromethod for Measuring Histamine in Human Plama , J Lab Clin Med 62:506-510 ( (Sept) ) 1963;.
Van Arsdel, P.P., and Sells, C.J.:  Antigenic Histamine Release From Passively Sensitized Human Leucocytes , Science 141: 1190-1191 ( (Sept 20) ) 1963;.
Noah, J.W.: " Anaphylactic Histamine Release and Schultz-Dale Reaction ," in Ackroyd, J.F. (ed.): Immunological Methods , Philadelphia: F.A. Davis Co., 1964;.
Shelley, W.B.:  Circulating Basophil as Indicator of Hyper-Sensitivity in Man: Experimental Novobiocin Sensitization , Arch Derm 88:759-767 ( (Dec) ) 1963;.
Uri, J.; Valu, G.; and Bekesi, I.:  Production of 6-Amino-Penicillanic Acid by Dermatophytes , Nature 200:896-897 ( (Nov 30) ) 1963;.
Udenfriend, S.: Fluorescence Assay in Biology and Medicine , New York: Academic Press, 1962;.
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