Comparison of Basophil Activation Test and Skin Testing Performances in NMBA Allergy

The Journal of Allergy and Clinical Immunology. in Practice
P DewachterPascale Nicaise-Roland

Abstract

Neuromuscular blocking agents (NMBAs) are the main agents involved during perioperative immediate hypersensitivity. The etiological diagnosis (IgE-mediated allergy vs nonallergy) is linked to the clinical presentation together with tryptase and histamine levels and skin test results. The role of basophil activation test (BAT) needs to be better defined in this setting. To assess the role of BAT compared with the results of skin testing in 31 patients experiencing immediate NMBA hypersensitivity and compare skin test results and BAT performances in the identification of alternative NMBAs. Histamine and tryptase levels were quantified. Anesthetic drugs, including NMBAs, were skin-tested. Basophil CD63 and CD203c expressions were measured in response to serial dilutions of the different NMBAs. Allergy and Nonallergy groups involved 19 and 12 patients, respectively. Circulating histamine and tryptase levels were significantly increased in allergic patients. In the Allergy group, while skin test results were positive in 100% (19 of 19) of the cases, BAT positivity to the culprit NMBA reached 78.9% (15 of 19) when combining CD63 and CD203c. NMBAs cross-reactivity was identified through skin testing and BAT in 36.8% (7 of 19) and 26.3...Continue Reading

Citations

Mar 13, 2019·Current Allergy and Asthma Reports·Lucila CamposPedro Giavina-Bianchi
Sep 27, 2019·Allergy·Cristobalina MayorgaMaría José Torres
Nov 16, 2018·Current Allergy and Asthma Reports·Oliver HemmingsAlexandra F Santos
Sep 30, 2020·Allergy·Adriana ArizaTahia D Fernandez
Jan 8, 2021·Current Allergy and Asthma Reports·Jerry KalangaraMerin Kuruvilla
Oct 12, 2020·The Journal of Allergy and Clinical Immunology. in Practice·Ana Dioun BroylesMariana Castells
Apr 10, 2021·The Journal of Allergy and Clinical Immunology·Pierre Bruhns, Sylvie Chollet-Martin

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