Case Report: Mast cell anergy: absence of symptoms after accidental re-exposure to amoxicillin/clavulanic acid 3 days after anaphylaxis

Loris Guyénard; Marie Tauber; Sophie Debord-Peguet; Frédéric Berard; Audrey Nosbaum; Florence Hacard; Mariana Castells; Jean-François Nicolas

doi:10.3389/falgy.2024.1366922

Case Report: Mast cell anergy: absence of symptoms after accidental re-exposure to amoxicillin/clavulanic acid 3 days after anaphylaxis

Front Allergy. 2024 Mar 11:5:1366922. doi: 10.3389/falgy.2024.1366922. eCollection 2024.

Authors

Loris Guyénard^#^{1

2}, Marie Tauber^#^{1

2}, Sophie Debord-Peguet^{2

3}, Frédéric Berard^{1

2}, Audrey Nosbaum^{1

2}, Florence Hacard^{1

2}, Mariana Castells⁴, Jean-François Nicolas^{1

2}

Affiliations

¹ Allergologie et Immunologie Clinique, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France.
² Team Epidermal Immunity and Allergy, Centre International de Recherche en Infectiologie (CIRI)-Université Claude Bernard Lyon 1-Inserm U1111-CNRS-ENS, Lyon, France.
³ Service d'Anesthésie-Réanimation Civilo-Militaire, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
⁴ Drug Hypersensitivity and Desensitization Center, Mastocytosis Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.

^# Contributed equally.

Abstract

Empty mast cell syndrome, also named post anaphylaxis mast cell anergy (PAMA), is a temporary state of loss of mast cell responsiveness after a severe immediate hypersensitivity reaction. In this study, we describe a case of PAMA after accidental re-exposure to amoxicillin in a patient who developed severe anaphylaxis to this drug three days earlier in the operating room. To our knowledge, this report is the second to document this phenomenon.

Keywords: beta-lactams; case report; drug allergy; skin test; systemic reaction.

Publication types

Case Reports

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article.