The oral cephalosporin derivative Cefaclor was administered to 22 patients with respiratory tract infections at a daily dosage of 3 x 500 mg. The average duration of the Cefaclor therapy was 10 days. In all patients improvement of the clinical picture and of objective criteria, such as fever, cough and sputum was observed. It was not possible to objectivate side effects by laboratory parameters. Gastrointestinal disturbances and allergic symptoms were only present in individual cases but did not significantly influence the clinical efficacy of Cefaclor.

Administration, Oral↗

PubMed1982

Detection of IgG sensitization of red cells with 125I staphylococcal protein A.

Most cases of immune hemolytic anemia are associated with a positive direct antiglobulin test. However, in some cases, the antiglobulin test is not sensitive enough to detect low levels of red-cell bound antibodies. This report describes a method using radiolabelled purified staphylococcal protein A which is capable of detecting IgG sensitization of red cells beyond the threshold of serologic techniques. It is less cumbersome than previously described methods and does not require antibody purification procedures. Its effectiveness was demonstrated for the detection of red-cell alloantibodies and in evaluation of patients with acquired hemolytic anemias associated with a negative direct antiglobulin test.

Anemia, Hemolytic, Autoimmune↗

PubMed1981

International collaborative study of four candidate reference preparations for the antigenic and hemolytic measurement of human serum complement components.

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Adolescent↗

PubMed1979

Determinations of penicilloyl specific IgE antibodies for the evaluation of hypersensitivity against penicillin.

Results from skin tests and radioallergosorbent test (penicilloyl G and penicilloyl V) were compared in 76 patients with suspected penicillin hypersensitivity and in 22 control subjects without such clinical symptoms. The test results were also correlated to the clinical history of adverse reactions and to the levels of total serum IgE. The overall agreement between skin test and RAST results was 89% in the patient group. Two of the control subjects without symptoms were professionally employed with penicillin production; one of them had circulating IgE-antibodies and the other exhibited positive skin tests. The skin tests were more frequently positive than the RAST test. By means of skin titration some of the skin tests were demonstrated to be false positive. The discrepancy can also be explained by the fact that skin reactions also occur in other situations than IgE-mediated adverse reactions. Circulating IgE-antibodies were not found in any of 23 cases where adverse reactions appeared later than 24 h after the latest penicillin administration. It is concluded that the measurement of circulating IgE-antibodies is a valuable aid in the diagnosis of penicillin allergy.

Adolescent↗

PubMed1979

[Immunomechanisms in drug-induced hemolytic anemias].

Among the acquired hemolytic anemias, drug-induced immune hemolytic anemias (IHA) play a significant role. Many different drugs are capable of causing IHA, alphamethyldopa and penicillins have been responsible for the greatest number of cases. For the majority of the other drugs single cases of IHA are reported. Drug-induced immune hemolysis may be mediated by different immune mechanisms including the immune cytotoxicity type (penicillins and cephalosporins) with predominantly extravascular hemolysis. Immune hemolysis of most other drugs is due to immune complexes formed by the drug and specific antibodies leading to intravascular hemolysis in the presence of complement activation. So far, the autoimmune type of IHA caused by alphamethyldopa is unexplained, serologically this form cannot be distinguished from warm antibody auto-IHA. The clinical importance of drug-induced IHA depends on the severity of anemia and the problem of diagnosis leading to adequate therapeutic measures. Only a small number of cases showing a positive direct antiglobulin (Coombs') test caused by drugs will develop IHA. Therefore this finding does not require absolutely withdrawal of the drug, but careful observation of the patient. The diagnosis of drug-induced IHA is necessary for its distinction from auto-IHA and other secondary IHA. The study of such IHA has great importance for the understanding of other drug-induced cytopenias and may give explanations of the pathogenetic mechanisms of yet unexplained autoimmune phenomena.

Anemia, Hemolytic, Autoimmune↗