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Intestinal mucosal permeability of children with cefaclor-associated serum sickness-like reactions

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Abstract

Although the serum sickness-like reaction (SSLR) in children after the administration of cefaclor has long been recognized, the exact mechanism of cefaclor-associated SSLR remains unclear. This study aims to investigate the association between intestinal mucosal permeability and cefaclor-associated SSLR in children. A total of 82 pediatric patients with upper respiratory tract infection following the cefaclor therapy was divided into cefaclor-associated SSLR positive group and negative group based on the presence or absence of SSLR after taking cefaclor, and 30 healthy volunteers served as control group. Urinary lactulose/mannitol (L/M) ratios and serum diamine oxidase (DAO) levels were determined in all cases on days 7, 9, 11, 13, and 15 after oral administration of cefaclor. The children in the control group were given the same measurements after enrollment in this study. From days 7 to 13, the urinary L/M ratio of children with cefaclor SSLR gradually increased and reached to the highest level of 0.38 ± 0.14 on day 13. Compared with the cefaclor-associated SSLR negative group and control group, urinary L/M ratios increased significantly in the cefaclor SSLR positive group on days 7, 9, 11, 13, and 15 after taking cefaclor, and serum levels of DAO following the treatment of cefaclor increased significantly in children with cefaclor SSLR on days 9, 11, 13, and 15. No significant difference in urinary L/M ratios and serum levels of DAO between SSLR negative group and control group through the entire experiment was observed. In conclusion, administration of cefaclor may induce SSLR in children by increasing the intestinal mucosal permeability and/or affecting the integrity of the intestinal mucosa. Determinations of urinary L/M ratios and serum DAO levels may be helpful for observing or predicting the occurrence of SSLR after administration of cefaclor, which will encourage physicians to proceed with extreme caution when prescribing cefaclor for pediatric patients.

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Acknowledgments

The authors are grateful to the children and parents who took part in the study. We also thank Dr. Shanshan Li (Iowa State University, USA) for helping in the modification of the manuscript and providing some useful suggestions in this study. Many thanks to Shenzhen Bureau of Science Technology and Information (grant: JC200903180532A to ZY), RFDP (20090002120055 to ZY), and Nanshan district Bureau of Science Technology for the funding of this study.

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No competing financial interests exist.

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Authors and Affiliations

  1. Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Tongji Medical College, Huazhong University of Science and Technology, 100 Xianggang Rd., Jiang An District, Wuhan, Hubei, 430016, People’s Republic of China

    Zhen Zhang, Yun Xiang & Xiaomei Wang

  2. Center for Biomedicine and Biotechnology, Division of Life Science, Graduate School at Shenzhen, Tsinghua University, Rm. 401, Bldg. L, Tsinghua Campus, University Town, Shenzhen, 518055, People’s Republic of China

    Hongbo Chen, Lin Mei & Yi Zheng

  3. Department of Gastroenterology, Wuhan Medical and Health Center for Women and Children, Tongji Medical College, Huazhong University of Science and Technology, 100 Xianggang Rd., Jiang An District, Wuhan, Hubei, 430016, People’s Republic of China

    Baoxiang Wang & Xiaofang Cai

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  1. Zhen Zhang
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  2. Yun Xiang
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  3. Baoxiang Wang
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  4. Hongbo Chen
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Corresponding authors

Correspondence to Yun Xiang or Yi Zheng.

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Zhen Zhang and Yun Xiang contributed equally to this work.

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Zhang, Z., Xiang, Y., Wang, B. et al. Intestinal mucosal permeability of children with cefaclor-associated serum sickness-like reactions. Eur J Pediatr 172, 537–543 (2013). https://doi.org/10.1007/s00431-012-1926-y

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  • DOI: https://doi.org/10.1007/s00431-012-1926-y

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