• Young Hee Nam, Eui Kyung Hwang, Ga Young Ban, Hyun Jung Jin, Hye Soo Yoo, Yoo Seob Shin, Young Min Ye, Dong Ho Nahm, Hae Sim Park, and Soo Keol Lee.
• Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
• Allergy Asthma Immun. 2015 May 1; 7 (3): 301-3.

AbstractCefotetan is a commonly prescribed second-generation cephalosporin that acts against a wide range of bacteria. However, cefotetan-induced hypersensitivity has rarely been reported. We report 2 cases of cefotetan-induced anaphylaxis with immunologic evaluation. The first case was a 70-year-old asthmatic woman who had dyspnea and hypotension during administration of cefotetan, in which high serum-specific IgE to cefotetan-human serum albumin (HSA) conjugate was detected by enzyme-linked immunosorbent assay. The second case was a 63-year-old asthmatic woman who complained of chest tightness and dyspnea during cefotetan infusion, in which high serum-specific IgG1 and IgG4 with no serum specific IgE to cefotetan-HSA conjugate was detected. The basophil activation test using basophils from the patient showed a significant up-regulation of CD63 with the addition of anti-IgG4 antibody compared with that in non-atopic healthy controls. In conclusion, cefotetan can induce anaphylaxis, which may involve both IgE- and IgG4-mediated responses in the pathogenic mechanism.

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