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Generalized urticaria occurred in a patient immediately after he had ingested penicillin tablets. Immunologic studies indicate that the reaction was probably mediated by penicilloyl-specific, skin-sensitizing antibodies. The circumstances accounting for this reaction are most likely the combined presence of penicilloyl-specific, skin-sensitizing antibodies of high avidity and low titers of blocking antibodies of the same specificity.
Fellner MJ, Levine BB, Baer RL. Immediate Reaction to Penicillin: Association With Penicilloyl-Specific Skin-Sensitizing Antibodies and Low Titers of Blocking (IgG) Antibodies. JAMA. 1967;202(9):909–911. doi:10.1001/jama.1967.03130220097026
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