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Utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice
INTRODUCTION: Perioperative anaphylactic reactions due to drugs and substances associated with general anesthesia can potentially be life‐threatening. The objective of this study was to investigate the significance of the basophil activation test (BAT) for allergy diagnosis work up. METHODS: A total...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5691303/ https://www.ncbi.nlm.nih.gov/pubmed/28580612 http://dx.doi.org/10.1002/iid3.175 |
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author | Eberlein, Bernadette Wigand, Sibylle Lewald, Heidrun Kochs, Eberhard Ring, Johannes Biedermann, Tilo Darsow, Ulf |
author_facet | Eberlein, Bernadette Wigand, Sibylle Lewald, Heidrun Kochs, Eberhard Ring, Johannes Biedermann, Tilo Darsow, Ulf |
author_sort | Eberlein, Bernadette |
collection | PubMed |
description | INTRODUCTION: Perioperative anaphylactic reactions due to drugs and substances associated with general anesthesia can potentially be life‐threatening. The objective of this study was to investigate the significance of the basophil activation test (BAT) for allergy diagnosis work up. METHODS: A total of 14 patients (5 men, 9 women; mean age: 57.8 years) with clinical records of anaphylactic reactions under general anesthesia were studied by means of anesthesia records, skin and serological tests. Eleven healthy subjects without any history of allergic sensitization to anaesthetic drugs served as controls. BATs based on stimulation of whole blood cells measuring CD63 activation of basophils and using CCR3 as basophil marker by flow cytometry (Flow CAST®, BÜHLMANN Laboratories AG, Schönenbuch, Switzerland) were performed with the following substances (in dependence on the history and the skin tests of the patient): analgesics (acetylsalicylic acid, celecoxib, diclofenac, ibuprofen, indometacin, metamizole, paracetamol, propyphenazone, tramadol), antibiotics (PPL (benzylpenicilloyl polylysine), MDM (minor determinant mixture), amoxicillin, cefuroxime, ciprofloxacin, doxycycline, erythromycin, roxithromycin, sulfamethoxazole, trimethoprim), local anesthetics (articaine, bupivacaine, lidocaine, prilocaine, procaine, methyl‐4‐hydroxybenzoate), narcotics and NMBA (atracurium, cisatracurium, etomidate, neostigmine, midazolam, mivacurium, pancuronium, propofol, pyridostigmine, succinylcholine, sufentanil, thiopental, vecuronium), and other individual substances. RESULTS: Three patients showed positive results in the BAT: One to metamizole, one to PPL, and one to pancuronium. BATs with these substances were negative in controls. CONCLUSIONS: The BAT should be used complementary to skin tests, especially if IgE‐mediated mechanisms are presumed and skin tests are inconclusive. A positive reaction in BAT identifies the culprit agent with high probability. |
format | Online Article Text |
id | pubmed-5691303 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-56913032017-11-24 Utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice Eberlein, Bernadette Wigand, Sibylle Lewald, Heidrun Kochs, Eberhard Ring, Johannes Biedermann, Tilo Darsow, Ulf Immun Inflamm Dis Original Research INTRODUCTION: Perioperative anaphylactic reactions due to drugs and substances associated with general anesthesia can potentially be life‐threatening. The objective of this study was to investigate the significance of the basophil activation test (BAT) for allergy diagnosis work up. METHODS: A total of 14 patients (5 men, 9 women; mean age: 57.8 years) with clinical records of anaphylactic reactions under general anesthesia were studied by means of anesthesia records, skin and serological tests. Eleven healthy subjects without any history of allergic sensitization to anaesthetic drugs served as controls. BATs based on stimulation of whole blood cells measuring CD63 activation of basophils and using CCR3 as basophil marker by flow cytometry (Flow CAST®, BÜHLMANN Laboratories AG, Schönenbuch, Switzerland) were performed with the following substances (in dependence on the history and the skin tests of the patient): analgesics (acetylsalicylic acid, celecoxib, diclofenac, ibuprofen, indometacin, metamizole, paracetamol, propyphenazone, tramadol), antibiotics (PPL (benzylpenicilloyl polylysine), MDM (minor determinant mixture), amoxicillin, cefuroxime, ciprofloxacin, doxycycline, erythromycin, roxithromycin, sulfamethoxazole, trimethoprim), local anesthetics (articaine, bupivacaine, lidocaine, prilocaine, procaine, methyl‐4‐hydroxybenzoate), narcotics and NMBA (atracurium, cisatracurium, etomidate, neostigmine, midazolam, mivacurium, pancuronium, propofol, pyridostigmine, succinylcholine, sufentanil, thiopental, vecuronium), and other individual substances. RESULTS: Three patients showed positive results in the BAT: One to metamizole, one to PPL, and one to pancuronium. BATs with these substances were negative in controls. CONCLUSIONS: The BAT should be used complementary to skin tests, especially if IgE‐mediated mechanisms are presumed and skin tests are inconclusive. A positive reaction in BAT identifies the culprit agent with high probability. John Wiley and Sons Inc. 2017-06-05 /pmc/articles/PMC5691303/ /pubmed/28580612 http://dx.doi.org/10.1002/iid3.175 Text en © 2017 The Authors. Immunity, Inflammation and Disease Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Eberlein, Bernadette Wigand, Sibylle Lewald, Heidrun Kochs, Eberhard Ring, Johannes Biedermann, Tilo Darsow, Ulf Utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice |
title | Utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice |
title_full | Utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice |
title_fullStr | Utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice |
title_full_unstemmed | Utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice |
title_short | Utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice |
title_sort | utility of basophil activation testing to assess perioperative anaphylactic reactions in real‐world practice |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5691303/ https://www.ncbi.nlm.nih.gov/pubmed/28580612 http://dx.doi.org/10.1002/iid3.175 |
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