Comparing Basophil Activation Test and Specific IgE Assay in the Diagnosis  of Allergy to Penicillin G and Ibuprofen

Parastoo  Shakerin; Raheleh Shokouhi  Shoormasti; Mohammad Reza  Fazlollahi; Mahsa  Jafari; Mona  Delkhah; Parichehr  Bahraini; Leila  Moradi; Maryam  Mahloujirad; Masoud  Movahedi; Homa  Sadri; Morteza  Fallahpour; Alireza  Shafiei; Fariborz  Zandieh; Mohammad  Tajdini; Zahra  Pourpak

doi:10.18502/ijaai.v24i6.20153

Parastoo Shakerin Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Raheleh Shokouhi Shoormasti Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Reza Fazlollahi Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Mahsa Jafari Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Mona Delkhah Department of Flow Cytometry, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
Parichehr Bahraini Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Leila Moradi Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Maryam Mahloujirad Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Masoud Movahedi Department of Immunology and Allergy, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
Homa Sadri Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
Morteza Fallahpour Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Alireza Shafiei Department of Pediatrics, School of Medicine, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
Fariborz Zandieh Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Tajdini Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Zahra Pourpak Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijaai.v24i6.20153

Keywords: Basophil activation test; β-lactam; Drug hypersensitivity; Nonsteroidal anti-inflammatory drugs; Specific IgE

Abstract

The risks associated with in vivo tests in the diagnosis of immediate drug hypersensitivities result in evaluating alternative in vitro tests, such as the Basophil Activation Test (BAT). This pilot study aimed to set up a BAT and compare it with a specific Immunoglobulin E (sIgE) assay for penicillin G and Ibuprofen in patients with immediate hypersensitivity to β-lactams or nonsteroidal anti-inflammatory drugs (NSAIDs).

Eleven subjects with a clear history of immediate hypersensitivity to one of the β-lactams (n=5), the NSAIDs (n=3), or both (n=3) entered this study. BAT and sIgE assays were performed regarding the patient’s history.

The most frequent manifestations were angioedema, shortness of breath, urticaria, and nausea. Eight patients had anaphylactic reactions. The results presented a positive BAT for penicillin G and one for Ibuprofen. Moreover, three patients with a history of the β-lactams reaction demonstrated positive sIgE to β-lactams in the ImmunoCAP. Despite a lack of agreement between the positive results of the BAT and sIgE assay, five patients were identified by one of these methods.

Despite positive BAT and sIgE results in two and three patients, respectively, the risks, high cost, and time-consuming nature of drug challenges render these tests valuable for reducing the number of patients who are candidates for a drug challenge.