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Penicilloyl G (DRUG) (Allergen Specific IgE)

Penicilloyl G (Drug) Allergen Specific IgE, Penicilloyl G, Drug (c1)

Test Codes

Antrim #31940, EPIC: LAB5688, SOFT: EPEG

Department

Special Testing Allergens

Specimen Collection Criteria

Collect: One Gold-top SST tube.

Twenty individual allergen assays or allergen screens can be performed on one 5 mL Gold-top SST tube. Each allergen assay requires 100 mcL of serum.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within two hours of collection.

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8°C or 36-46°F).

Rejection Criteria

Plasma specimens.

Severely lipemic or hemolyzed specimens.

In-Lab Processing

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Room temperature is acceptable for a maximum of two hours.

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes and Microtainers^® with Separator Gel
Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Red-top Tubes and Microtainers^® without Separator Gel
Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 1 month

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Special Testing Laboratory

Performed

Monday – Friday.
Results available the next business day.

Reference Range

Allergy Reference Range: Less than 0.35 kU/L. 

Range (kU/L)	Class	Interpretation
Less than or equal to 0.34	0	Negative
0.35-0.69	1	Low
0.70-3.49	2	Medium
3.50-17.49	3	High
17.50-49.99	4	Very High
50.0-100.0	5	Very High
Greater than 100	6	Very High

Test Methodology

Fluorescence Enzyme Immunoassay (FEIA).

Interpretation

The allergen class may not be predictive of clinical disease in some patients. The diagnosis of allergy should be based upon patient history and clinical findings. The diagnosis of allergy should not be based upon laboratory findings alone.

Clinical Utility

Positive assay results indicate a high probability of allergic disease. Negative assay results effectively rule out allergy induced by those allergens.

Clinical Disease

Beta-lactam drugs such as penicillin are the most common agents of drug-induced hypersensitivity (1). Penicilloyl- derivatives of penicillins are the major allergens found in penicillin-sensitized individuals. The remaining 5% of tissue- bound by-products are called "minor antigenic determinants" (1). The minor antigenic determinants are termed as such due to the quantity and not the clinical importance of this fraction (1).

Penicillin hypersensitivity falls under one of three categories, immediate, accelerated and late. An immediate reaction occurs within 30 minutes of drug ingestion and is characterized by hives and more seriously anaphylaxis (1). Immediate reactions occur in those individuals who have previously been exposed to Penicillin. Anaphylaxis, an immediate hypersensitivity reaction, is seen most commonly with Penicillin and is responsible for 200 - 500 deaths each year in the United States (2).

An accelerated reaction occurs between 2 - 72 hours after antibiotic administration and symptoms include hives, wheezing, pruritus, and swelling of the throat (1).

The most common form of penicillin hypersensitivity reactions, or late reactions, take place 3 days or more after the exposure to the drug. Characterized by urticaria, rash, joint pain, and fever, the late hypersensitivity reactions are often not IgE-mediated responses (1).

Reference

1. Lawlor, Glenn, Thomas Fischer, and Daniel Adelman. Manual of Allergy and Immunology. 3rd ed. Little, Brown and Company: Boston. 1995. Pp. 273.
2. Fireman, Philip, and Raymond Slavin. Atlas of Allergies. Mosby-Wolfe: 1996. Pp. 71.

CPT Codes

86003
LOINC: 6851-0

Contacts

Last Updated

3/10/2023