Presentation: A case of ofloxacin-induced anaphylaxis by non-IgE, but specific IgG4-mediated responses ( World Allergy Congress)

Saturday, 17 October 2015

Hall D1 Foyer (Floor 3) (Coex Convention Center)

Daehong Seo, MD , Allergy and Clinical Immunology, Cheonan Chungmu Hospital, Cheonan, South Korea

Ji Hye Kim, MD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Young-Mok Lee, MD , GF Allergy Clinic, Seoul, South Korea

Young Min Ye, MD, PhD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Hae-Sim Park, MD, PhD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Anaphylaxis induced by ofloxacin has been rarely reported, and its pathogenetic mechanism has not yet been fully understood. This is a report of non-IgE mediated ofloxacin-induced anaphylaxis in a 20-year-old female patient who suffered from allergic rhinitis and had a previous history of acute urticaria induced by nonsteroidal anti-inflammatory drugs. She developed generalized urticaria and anaphylaxis following oral ingestion of ofloxacin. When we measured specific serum antibodies to ofloxacin-human serum albumin (HSA) conjugate using ELISA, a high level of specific serum IgG4 was detected, but serum specific IgE was not detectable. Moreover, a basophil activation test showed a significant up-regulation of CD203c with addition of ofloxacin and anti-IgG4 antibody in the patient with no significant changes in 3 non atopic healthy controls. These findings suggest that ofloxacin can induce anaphylaxis via pathogenetic mechanisms involving non IgE-mediated, but specific IgG4-mediated responses.

4000 A case of ofloxacin-induced anaphylaxis by non-IgE, but specific IgG4-mediated responses