Adverse drug reactions.

Adverse drug reactions are a common problem for patients and their physicians. About 6% to 10% of adverse drug reactions are allergic. Obtaining a detailed history is very important.

Elevated in vitro IL-4 production in a patient with elevated serum IgE.

Background: We have cared for an unusual patient with serum IgE concentrations of up to 150,000 IU/mL who did not have the hyper-IgE syndrome.

Objective: Our objective in this study was to compare the regulation of in vitro IgE synthesis in this patient with results reported for in vitro IgE production by patients with the hyper-IgE syndrome.

Methods: We utilized an enzyme-linked immunosorbent assay to measure in vitro IgE production under varying conditions.

Proving penicillin allergy.

Allergic reactions to penicillin are usually short-lived and reversible, but they can be fatal. What causes these reactions? Can they be avoided? How is the risk of penicillin allergy evaluated? Drs Erffmeyer and Blaiss describe the full spectrum of allergic, immune, and nonimmune reactions to penicillin and discuss how to assess and treat patients with suspected penicillin allergy.