Anaphylaxis caused by cloxacillin: Diagnosis with seriated analysis by way of basophil activation test

Trabado, Ana Rodríguez; Hijón, Carmen Cámara; Carreño, Sergio Luis Porcel; Martin, E.; Peral, Carmen; Navarro, Gemma Pereira; Timón, S Jiménez; Arbeiza, Francisco Javier Hernández; Pereira, Luis Fernández

doi:10.2500/aap.2006.27.2863

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…However, at least 2 weeks should elapse after the acute phase in order to avoid the presence of a high percentage of activated basophils in basal conditions [55]. Moreover, in-vitro tests becoming negative is not always accompanied by good tolerance to the drugs, although this is difficult to confirm because a new contact with the drug could have an influence on resensitization [56].…”

Section: Basophil Activation Test In Allergic Reactions To Other Drugsmentioning

confidence: 98%

Basophil activation tests in the evaluation of immediate drug hypersensitivity

Sánz

Gamboa

Mayorga

2009

Current Opinion in Allergy &Amp; Clinical Immunology

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BAT sensitivity in beta-lactam allergy was 50%, and specificity ranged from 89 to 97%. There are several studies to validate the BAT in allergy to muscle relaxants showing a sensitivity ranging from 54 to 64% with a specificity of 100 and 93%. The sensitivity of a test for evaluating immediate allergic reactions to drugs may decrease over time. To date, the BAT is the only in-vitro diagnostic method that has been validated for the diagnosis of both IgE-mediated and hypersensitivity reactions to NSAIDs. With respect to other drugs, they are nonetheless interesting as they include the evaluation of allergy to drugs that cannot be studied by other in-vitro techniques. All these data suggest that although a full validation of the test is required, BAT is a potential diagnostic method for evaluating immediate allergic reactions to drugs and NSAID hypersensitivity reactions.

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Section: Basophil Activation Test In Allergic Reactions To Other Drugsmentioning

confidence: 98%

Basophil activation tests in the evaluation of immediate drug hypersensitivity

Sánz

Gamboa

Mayorga

2009

Current Opinion in Allergy &Amp; Clinical Immunology

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“…The procedure followed was the one recommended by the supplier and previously described. 26 Acquisition was performed on 800 basophils per sample. When it was not possible, tests with Ͻ200 cells were excluded.…”

Section: Basophil Activation Testmentioning

confidence: 99%

Basophil activation test for the in vitro diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity

Rodríguez-Trabado

Cámara-Hijón

Ramos

et al. 2008

allergy asthma proc

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There is need for an in vitro diagnostic test for hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs). The purpose of this study was to assess the reliability of one such diagnostic, the basophil activation test. Forty-three drug hypersensitive patients referring several immediate reactions (anaphylaxis, urticaria, angioedema, asthma, and rhinoconjunctivitis) to one or more NSAIDs and 29 controls participated. Using the Basotest commercial kit, 63 determinations were performed with the drugs implicated in the adverse reactions (ASA, ibuprofen, metamizol, diclofenac, paracetamol, and ketorolac). In 16 patients additional determinations were made with other chemically unrelated NSAIDs. Forty-two determinations were made for controls. The analysis was performed by flow colorimetric cytometry and double staining with the monoclonal antibodies anti-IgE and anti-CD63. A Basophil Activation Index (percentage of activated basophils after allergen stimulation/percentage of basally activated basophils) of two or more was considered a positive result. Specificity of 100% and sensitivity of 42.85% were achieved. The positive predictive value was 100%, and the negative predictive value was 53.84%. In 35.29% of intolerant patients there was a positive reaction to at least two drugs implicated in adverse reactions, and in 27.27% of these patients there was a positive reaction to other chemically unrelated NSAIDs. The basophil activation test is useful for the in vitro diagnosis of NSAID hypersensitivity, providing good specificity and positive predictive value and diagnostic reliability in the assessment of NSAID intolerance.

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“…β -Lactams [88,89,90,91,92,93,94,95,96]. In quoting only one [88] of the several validated studies on BAT in the diagnosis of β-lactam allergy and in pretending that CD63 BAT was only performed in patients with positive skin tests to β-lactams, Kleine-Tebbe et al[ 1] have presented an incomplete view of the literature.…”

Section: Clinical Indications Of Batmentioning

confidence: 99%

“…Many of these studies have been reviewed recently [8,9,10]. Herewith, tables 1, 2, 3, 4, 5, 6, 7summarize the results of validated clinical studies performed with various allergens such as inhalant allergens [25,26,27,28,29,30,31,32,33] (table 1), hymenoptera venoms [34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56] (table 2), latex [57,58,59,60,61,62,63] (table 3), food [64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80] (table 4) and drugs [81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,…”

Section: Clinical Issues In the Diagnostic Use Of Batmentioning

confidence: 99%

Diagnostic Tests Based on Human Basophils: More Potentials and Perspectives than Pitfalls

Weck

Sánz

Gamboa

et al. 2008

Int Arch Allergy Immunol

172

178

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For the diagnosis of allergy, cellular basophil activation tests (BAT), e.g. histamine or sulfidoleukotriene release tests, have long been introduced, but the expression of basophil activation markers such as CD63 and CD203c detected by flow cytometry has attracted more recent attention. A recent opinion paper in this Journal has stressed not only the potential but also the possible pitfalls of flow-cytometric BAT. We have applied clinical validation of various BAT in various ways for several years, and our experience shows that these new technologies have more potentials and perspectives than pitfalls. A comprehensive review of clinically validated studies on allergy to aeroallergens, insect venoms, latex, food allergens and drugs, e.g. myorelaxants, β-lactams, pyrazolones and non-steroidal anti-inflammatory drugs, as well as chronic urticaria shows clearly that even with different protocols, reproducible and meaningful results can be obtained. Although the available technologies may still be optimized and better standardized, there are no serious reasons to deprive allergic patients of clinically indicated BAT, which can be performed reliably by any laboratory with allergy and flow-cytometric capacity and expertise.

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Anaphylaxis caused by cloxacillin: Diagnosis with seriated analysis by way of basophil activation test

Cited by 10 publications

References 10 publications

Basophil activation tests in the evaluation of immediate drug hypersensitivity

Basophil activation tests in the evaluation of immediate drug hypersensitivity

Basophil activation test for the in vitro diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity

Diagnostic Tests Based on Human Basophils: More Potentials and Perspectives than Pitfalls

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