Basophil activation test, anaphylaxis

The detection of reactions mediated by specific IgE to agents triggering anaphylaxis may be achieved by means of serological methods serum-specific IgE, or by means of cellular tests which determine the release of basophil mediators (leukotrienes and histamine) or by means of the analysis of basophil expression markers, a technique known as the basophil activation test (BAT). 

Unfortunately there is no commercial assay for routine measurement of serum levels of RCM-specific IgE antibodies. The reliability of other in vitro tests, such as the basophil activation test, has not yet been established. Results from individual patients indicate that the basophil activation test may be helpful [36]. However, at the moment it is only added on an experimental scientific basis. Provocation is not generally recommended, as intravenous applications of as low as 0.5-1 ml RCM have led to severe anaphylaxis [41]. 

Ben Said B, Leray V, Nicolas JF, Rozieres A, Berard F. Methylpredniso-lone-induced anaphylaxis diagnosis by skin test and basophil activation test. Allergy 2010 65(4) 531-2. 

Dewachter P, Nicaise-Roland P, Kalaboka S, Lefevre J, Chollet-Martin S. Anaphylaxis to amidatrizoate proved by skin testing and flow cytometry-based basophil activation test. Allergy 2009 64 496-502. 

If patients have experienced anaphylaxis, the identification of any possible elicitor is important to help avoid further episodes. With skin tests and specific IgE antibodies combined with history, a relevant allergy may be detected. Cellular tests monitoring basophil histamine release or basophil activation may be helpful in some patients who resist diagnosis by standard means [26,31]. 

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