Basophil Activation Test in Immediate-Type Hypersensitivity
Reactions to Betalactams Using CD63 and CCR3 in Thailand
Pongtong Puranitee MD, MHPE1, Ticha Rerkpattanapipat MD2, Wasu Kamchaisatian MD1, Soamarat Vilaiyuk MD1,
Wiparat Manuyakorn MD, PhD1, Sakda Arj-Ong Vallibhakara MD, PhD3, Suwat Benjaponpitak MD1
Affiliation :
1 Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
2 Division of Allergy, Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand
3 Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine usefulness of basophil activation test [BAT] in diagnosis of immediate betalactam [BL] allergy, and compare
the role of diagnosis BAT with standard testing, skin test [ST], and drug provocation test [DPT] in patients with history suspected
of drug allergy in Thailand.
Materials and Methods : Cross-sectional study of (cid:976)ifteen patients with an history of immediate hypersensitivity reactions to common
BL drug group, at Ramathibodi Hospital between 2010 and 2012. All subjects underwent ST, and DPT if ST was negative. BAT was
done in all patients.
Results : Fifteen patients (10 children and 5 adult), including seven male and eight female cases with history of highly indicated
immediate type allergic reactions to beta lactam were examined. Five presented with anaphylaxis and 10 with urticarial rash/
angioedema. From (cid:976)ifteen patients, eight patients were con(cid:976)irmed allergic to BL, where four had ST positivity, and four had positive
DPT. The present study found one patient with severe anaphylaxis that had negative ST, but could not undergo DPT due to underlying
diseases. The alternative test BAT yielded positive result. Four of the eight patients were con(cid:976)irmed as BL allergic patients with
positive BAT (50%). None of the patients with negative drug testing had positive BAT. Estimated sensitivity of ST was similar to
BAT at 50%, while speci(cid:976)icity of BAT in the present study was 100%. The result yielded higher sensitivity, such as 62%, when we
combined both tests together (ST and BAT). The authors observed BAT positive results in 75% of patients with positive ST, and
25% of patients positive DPT.
Conclusion : BAT has an advantage in patients contraindicated to perform DPT. Moreover, BAT can avoid the risk of reproducible
reactions from in vivo testing, especially in high-risk patients allergic to BL. BAT is a promising alternate investigation tool ensuring
patients’ safety.
Keywords : BL hypersensitivity, Drug allergy, Drug hypersensitivity, Immediate type hypersensitivity, Drug allergy testing
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