Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Drugs in R&D
Published in: Drugs in R&D 2/2017

Open Access 01-06-2017 | Review Article

In Vitro Diagnosis of Immediate Drug Hypersensitivity Anno 2017: Potentials and Limitations

Authors: I. I. Decuyper, E. A. Mangodt, A. L. Van Gasse, K. Claesen, A. Uyttebroek, M. Faber, V. Sabato, C. H. Bridts, C. Mertens, M. M. Hagendorens, L. S. De Clerck, Didier G. Ebo

Published in: Drugs in R&D | Issue 2/2017

Login to get access

Abstract

Background

For most physicians, quantification of drug-specific immunoglobulin E (drug-sIgE) antibodies constitutes the primary in vitro measure to document immediate drug hypersensitivity reactions (IDHR). Unfortunately, this is often insufficient to correctly identify patients with IgE-mediated IDHR and impossible for non-IgE-mediated IDHR that result from alternative routes of basophil and mast cell activation. In these difficult cases, diagnosis might benefit from cellular tests such as basophil activation tests (BAT).

Aim

The aim was to review the potential and limitations of quantification of sIgE and BAT in diagnosing IDHR. The utility of quantification of serum tryptase is discussed.

Methods

A literature search was conducted using the key words allergy, basophil activation, CD63, CD203c, diagnosis, drugs, hypersensitivity, flow cytometry, specific IgE antibodies; this was complemented by the authors’ own experience.

Results

The drugs that have been most studied with both techniques are β-lactam antibiotics and curarizing neuromuscular blocking agents (NMBA). For sIgE morphine, data are available on the value of this test as a biomarker for sensitization to substituted ammonium structures that constitute the major epitope of NMBA, especially rocuronium and suxamethonium. For the BAT, there are also data on non-steroidal anti-inflammatory drugs (NSAIDs) and iodinated radiocontrast media. For β-lactam antibiotics, sensitivity and specificity of sIgE varies between 0 and 85% and 52 and 100%, respectively. For NMBA, sensitivity and specificity varies between 38.5 and 92% and 85.7 and 100%, respectively. Specific IgE to morphine should not be used in isolation to diagnose IDHR to NMBA nor opiates. For the BAT, sensitivity generally varies between 50 and 60%, whereas specificity attains 80%, except for quinolones and NSAIDs.

Conclusions

Although drug-sIgE assays and BAT can provide useful information in the diagnosis of IDHR, their predictive value is not absolute. Large-scale collaborative studies are mandatory to harmonize and optimize test protocols and to establish drug-specific decision thresholds.
Literature
1.
Demoly P, Romano A, Botelho C, Bousquet-Rouanet L, Gaeta F, Silva R, et al. Determining the negative predictive value of provocation tests with beta-lactams. Allergy. 2010;65(3):327–32.PubMedCrossRef
2.
McNeil BD, Pundir P, Meeker S, Han L, Undem BJ, Kulka M, et al. Identification of a mast-cell-specific receptor crucial for pseudo-allergic drug reactions. Nature. 2015;519(7542):237–41.PubMedCrossRef
3.
Spoerl D, D’Incau S, Roux-Lombard P, Harr T, Czarnetzki C. Non-IgE-dependent hypersensitivity to rocuronium reversed by sugammadex: report of three cases and hypothesis on the underlying mechanism. Int Arch Allergy Immunol. 2016;169(4):256–62.PubMedCrossRef
4.
Ishizaka K, Ishizaka T. Physicochemical properties of reaginic antibody. 1. Association of reaginic activity with an immunoglobulin other than gammaA- or gammaG-globulin. J Allergy. 1966;37(3):169–85.PubMedCrossRef
5.
Johansson SG, Bennich H. Immunological studies of an atypical (myeloma) immunoglobulin. Immunology. 1967;13(4):381–94.PubMedPubMedCentral
6.
Johansson SG. In vitro diagnosis of reagin-mediated allergic diseases. Allergy. 1978;33(6):292–8.PubMedCrossRef
7.
Hamilton RG. Clinical laboratory assessment of immediate-type hypersensitivity. J Allergy Clin Immunol. 2010;125(2 Suppl 2):S284–96.PubMedCrossRef
8.
Knol EF, Mul FP, Jansen H, Calafat J, Roos D. Monitoring human basophil activation via CD63 monoclonal antibody 435. J Allergy Clin Immunol. 1991;88(3 Pt 1):328–38.PubMedCrossRef
9.
Bridts CH, Sabato V, Mertens C, Hagendorens MM, De Clerck LS, Ebo DG. Flow cytometric allergy diagnosis: basophil activation techniques. Methods Mol Biol. 2014;1192:147–59.PubMedCrossRef
10.
Buhring HJ, Seiffert M, Giesert C, Marxer A, Kanz L, Valent P, et al. The basophil activation marker defined by antibody 97A6 is identical to the ectonucleotide pyrophosphatase/phosphodiesterase 3. Blood. 2001;97(10):3303–5.PubMedCrossRef
11.
Buhring HJ, Streble A, Valent P. The basophil-specific ectoenzyme E-NPP3 (CD203c) as a marker for cell activation and allergy diagnosis. Int Arch Allergy Immunol. 2004;133(4):317–29.PubMedCrossRef
12.
Monneret G, Benoit Y, Debard AL, Gutowski MC, Topenot I, Bienvenu J. Monitoring of basophil activation using CD63 and CCR3 in allergy to muscle relaxant drugs. Clin Immunol (Orlando, Fla). 2002;102(2):192–9.CrossRef
13.
Chirumbolo S, Ortolani R, Vella A. CCR3 as a single selection marker compared to CD123/HLADR to isolate basophils in flow cytometry: some comments. Cytom Part A: J Int Soc Anal Cytol. 2011;79(2):102–6.CrossRef
14.
Hausmann OV, Gentinetta T, Fux M, Ducrest S, Pichler WJ, Dahinden CA. Robust expression of CCR3 as a single basophil selection marker in flow cytometry. Allergy. 2011;66(1):85–91.PubMedCrossRef
15.
Chirumbolo S. Major pitfalls in BAT performance may be caused by gating protocols and CD63% cut off evaluation. Cytom Part A: J Int Soc Anal Cytol. 2014;85(5):382–5.CrossRef
16.
MacGlashan D Jr. Expression of CD203c and CD63 in human basophils: relationship to differential regulation of piecemeal and anaphylactic degranulation processes. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2010;40(9):1365–77.CrossRef
17.
Sabato V, Verweij MM, Bridts CH, Levi-Schaffer F, Gibbs BF, De Clerck LS, et al. CD300a is expressed on human basophils and seems to inhibit IgE/FcepsilonRI-dependent anaphylactic degranulation. Cytom Part B Clin Cytom. 2012;82(3):132–8.CrossRef
18.
Ebo DG, Dombrecht EJ, Bridts CH, Aerts NE, de Clerck LS, Stevens WJ. Combined analysis of intracellular signalling and immunophenotype of human peripheral blood basophils by flow cytometry: a proof of concept. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2007;37(11):1668–75.CrossRef
19.
Verweij MM, Sabato V, Nullens S, Bridts CH, De Clerck LS, Stevens WJ, et al. STAT5 in human basophils: IL-3 is required for its FcepsilonRI-mediated phosphorylation. Cytom Part B Clin Cytom. 2012;82(2):101–6.CrossRef
20.
Ebo DG, Bridts CH, Mertens CH, Hagendorens MM, Stevens WJ, De Clerck LS. Analyzing histamine release by flow cytometry (HistaFlow): a novel instrument to study the degranulation patterns of basophils. J Immunol Methods. 2012;375(1–2):30–8.PubMedCrossRef
21.
Fontaine C, Mayorga C, Bousquet PJ, Arnoux B, Torres MJ, Blanca M, et al. Relevance of the determination of serum-specific IgE antibodies in the diagnosis of immediate beta-lactam allergy. Allergy. 2007;62(1):47–52.PubMedCrossRef
22.
Silva R, Cruz L, Botelho C, Castro E, Cadinha S, Castel-Branco MG, et al. Immediate hypersensitivity to penicillins with negative skin tests–the value of specific IgE. Eur Ann Allergy Clin Immunol. 2009;41(4):117–9.PubMed
23.
Qiao HL, Li Z, Yang J, Tian X, Gao N, Jia LJ. Hypersensitivity reactions to penicillins: studies in a group of patients with negative benzylpenicillin G skin test. J Clin Pharm Ther. 2009;34(3):249–54.PubMedCrossRef
24.
Hjortlund J, Mortz CG, Skov PS, Bindslev-Jensen C. Diagnosis of penicillin allergy revisited: the value of case history, skin testing, specific IgE and prolonged challenge. Allergy. 2013;68(8):1057–64.PubMedCrossRef
25.
Torres MJ, Romano A, Mayorga C, Moya MC, Guzman AE, Reche M, et al. Diagnostic evaluation of a large group of patients with immediate allergy to penicillins: the role of skin testing. Allergy. 2001;56(9):850–6.PubMedCrossRef
26.
Fernandez TD, Torres MJ, Blanca-Lopez N, Rodriguez-Bada JL, Gomez E, Canto G, et al. Negativization rates of IgE radioimmunoassay and basophil activation test in immediate reactions to penicillins. Allergy. 2009;64(2):242–8.PubMedCrossRef
27.
Macy E, Goldberg B, Poon KY. Use of commercial anti-penicillin IgE fluorometric enzyme immunoassays to diagnose penicillin allergy. Ann Allergy Asthma Immunol: Off Publ Am Coll Allergy Asthma Immunol. 2010;105(2):136–41.CrossRef
28.
Aberer W, Zidarn M, Kranke B. IgE antibodies to penicillin are indicative for but not conclusive proof of penicillin allergy. Br J Dermatol. 2006;154(6):1209–10.PubMedCrossRef
29.
Vultaggio A, Matucci A, Virgili G, Rossi O, Fili L, Parronchi P, et al. Influence of total serum IgE levels on the in vitro detection of beta-lactams-specific IgE antibodies. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2009;39(6):838–44.CrossRef
30.
Vultaggio A, Virgili G, Gaeta F, Romano A, Maggi E, Matucci A. High serum beta-lactams specific/total IgE ratio is associated with immediate reactions to beta-lactams antibiotics. PLoS One. 2015;10(4):e0121857.PubMedPubMedCentralCrossRef
31.
Johansson SG, Adedoyin J, van Hage M, Gronneberg R, Nopp A. False-positive penicillin immunoassay: an unnoticed common problem. J Allergy Clin Immunol. 2013;132(1):235–7.PubMedCrossRef
32.
Macy E. Penicillin allergy: optimizing diagnostic protocols, public health implications, and future research needs. Curr Opin Allergy Clin Immunol. 2015;15(4):308–13.PubMedCrossRef
33.
Mirakian R, Leech SC, Krishna MT, Richter AG, Huber PA, Farooque S, et al. Management of allergy to penicillins and other beta-lactams. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2015;45(2):300–27.CrossRef
34.
Broz P, Harr T, Hecking C, Grize L, Scherer K, Jaeger KA, et al. Nonirritant intradermal skin test concentrations of ciprofloxacin, clarithromycin, and rifampicin. Allergy. 2012;67(5):647–52.PubMedCrossRef
35.
Empedrad R, Darter AL, Earl HS, Gruchalla RS. Nonirritating intradermal skin test concentrations for commonly prescribed antibiotics. J Allergy Clin Immunol. 2003;112(3):629–30.PubMedCrossRef
36.
Uyttebroek AP, Sabato V, Bridts CH, De Clerck LS, Ebo DG. Moxifloxacin hypersensitivity: uselessness of skin testing. J Allergy Clin Immunol Pract. 2015;3(3):443–5.PubMedCrossRef
37.
Seitz CS, Brocker EB, Trautmann A. Diagnostic testing in suspected fluoroquinolone hypersensitivity. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2009;39(11):1738–45.CrossRef
38.
Lobera T, Audicana MT, Alarcon E, Longo N, Navarro B, Munoz D. Allergy to quinolones: low cross-reactivity to levofloxacin. J Investig Allergol Clin Immunol. 2010;20(7):607–11.PubMed
39.
Fernandez TD, Ariza A, Palomares F, Montanez MI, Salas M, Martin-Serrano A, et al. Hypersensitivity to fluoroquinolones: the expression of basophil activation markers depends on the clinical entity and the culprit fluoroquinolone. Medicine. 2016;95(23):e3679.PubMedPubMedCentralCrossRef
40.
Aranda A, Mayorga C, Ariza A, Dona I, Rosado A, Blanca-Lopez N, et al. In vitro evaluation of IgE-mediated hypersensitivity reactions to quinolones. Allergy. 2011;66(2):247–54.PubMedCrossRef
41.
Ben Said B, Berard F, Bienvenu J, Nicolas JF, Rozieres A. Usefulness of basophil activation tests for the diagnosis of IgE-mediated allergy to quinolones. Allergy. 2010;65(4):535–6.PubMedCrossRef
42.
Rouzaire P, Nosbaum A, Denis L, Bienvenu F, Berard F, Cozon G, et al. Negativity of the basophil activation test in quinolone hypersensitivity: a breakthrough for provocation test decision-making. Int Arch Allergy Immunol. 2012;157(3):299–302.PubMedCrossRef
43.
Manfredi M, Severino M, Testi S, Macchia D, Ermini G, Pichler WJ, et al. Detection of specific IgE to quinolones. J Allergy Clin Immunol. 2004;113(1):155–60.PubMedCrossRef
44.
Mertes PM, Alla F, Trechot P, Auroy Y, Jougla E. Anaphylaxis during anesthesia in France: an 8-year national survey. J Allergy Clin Immunol. 2011;128(2):366–73.PubMedCrossRef
45.
Dong SW, Mertes PM, Petitpain N, Hasdenteufel F, Malinovsky JM. Hypersensitivity reactions during anesthesia. Results from the ninth French survey (2005–2007). Minerva Anestesiol. 2012;78(8):868–78.PubMed
46.
Leysen J, De Witte L, Bridts CH, Ebo DG. Anaphylaxis during general anaesthesia: a 10-year survey at the University Hospital Antwerp. Proc Belg R Acad Med. 2013;2:88–100.
47.
Antunes J, Kochuyt AM, Ceuppens JL. Perioperative allergic reactions: experience in a Flemish referral centre. Allergol Immunopathol. 2014;42(4):348–54.CrossRef
48.
Low AE, McEwan JC, Karanam S, North J, Kong KL. Anaesthesia-associated hypersensitivity reactions: seven years’ data from a British bi-specialty clinic. Anaesthesia. 2016;71(1):76–84.PubMedCrossRef
49.
Mertes PM, Malinovsky JM, Jouffroy L, Aberer W, Terreehorst I, Brockow K, et al. Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice. J Investig Allergol Clin Immunol. 2011;21(6):442–53.PubMed
50.
Guilloux L, Ricard-Blum S, Ville G, Motin J. A new radioimmunoassay using a commercially available solid support for the detection of IgE antibodies against muscle relaxants. J Allergy Clin Immunol. 1992;90(2):153–9.PubMedCrossRef
51.
Gueant JL, Mata E, Monin B, Moneret-Vautrin DA, Kamel L, Nicolas JP, et al. Evaluation of a new reactive solid phase for radioimmunoassay of serum specific IgE against muscle relaxant drugs. Allergy. 1991;46(6):452–8.PubMedCrossRef
52.
Harle DG, Baldo BA, Fisher MM. Immunoassays employing substituted ammonium compounds other than neuromuscular blocking drugs to increase the detection of IgE antibodies to these drugs. Mol Immunol. 1990;27(10):1039–45.PubMedCrossRef
53.
Baldo BA, Fisher MM. Diagnosis of IgE-dependent anaphylaxis to neuromuscular blocking drugs, thiopentone and opioids. Ann Fr Anesth Reanim. 1993;12(2):173–81.PubMedCrossRef
54.
Baldo BA, Fisher MM. Substituted ammonium ions as allergenic determinants in drug allergy. Nature. 1983;306(5940):262–4.PubMedCrossRef
55.
Didier A, Cador D, Bongrand P, Furstoss R, Fourneron P, Senft M, et al. Role of the quaternary ammonium ion determinants in allergy to muscle relaxants. J Allergy Clin Immunol. 1987;79(4):578–84.PubMedCrossRef
56.
Laxenaire MC, Mertes PM. Anaphylaxis during anaesthesia. Results of a two-year survey in France. Br J Anaesth. 2001;87(4):549–58.PubMedCrossRef
57.
Mertes PM, Laxenaire MC, Alla F. Anaphylactic and anaphylactoid reactions occurring during anesthesia in France in 1999–2000. Anesthesiology. 2003;99(3):536–45.PubMedCrossRef
58.
Mertes PM, Laxenaire MC. Adverse reactions to neuromuscular blocking agents. Curr Allergy Asthma Rep. 2004;4(1):7–16.PubMedCrossRef
59.
Mertes PM, Laxenaire MC, Lienhart A, Aberer W, Ring J, Pichler WJ, et al. Reducing the risk of anaphylaxis during anaesthesia: guidelines for clinical practice. J Investig Allergol Clin Immunol. 2005;15(2):91–101.PubMed
60.
Harle DG, Baldo BA, Fisher MM. Detection of IgE antibodies to suxamethonium after anaphylactoid reactions during anaesthesia. Lancet (London, England). 1984;1(8383):930–2.CrossRef
61.
Harle DG, Baldo BA, Fisher MM. Assays for, and cross-reactivities of, IgE antibodies to the muscle relaxants gallamine, decamethonium and succinylcholine (suxamethonium). J Immunol Methods. 1985;78(2):293–305.PubMedCrossRef
62.
Harboe T, Guttormsen AB, Irgens A, Dybendal T, Florvaag E. Anaphylaxis during anesthesia in Norway: a 6-year single-center follow-up study. Anesthesiology. 2005;102(5):897–903.PubMedCrossRef
63.
Fisher MM, Baldo BA. Immunoassays in the diagnosis of anaphylaxis to neuromuscular blocking drugs: the value of morphine for the detection of IgE antibodies in allergic subjects. Anaesth Intensive Care. 2000;28(2):167–70.PubMed
64.
Florvaag E, Johansson SG, Oman H, Venemalm L, Degerbeck F, Dybendal T, et al. Prevalence of IgE antibodies to morphine. Relation to the high and low incidences of NMBA anaphylaxis in Norway and Sweden, respectively. Acta Anaesthesiol Scand. 2005;49(4):437–44.PubMedCrossRef
65.
Ebo DG, Venemalm L, Bridts CH, Degerbeck F, Hagberg H, De Clerck LS, et al. Immunoglobulin E antibodies to rocuronium: a new diagnostic tool. Anesthesiology. 2007;107(2):253–9.PubMedCrossRef
66.
Uyttebroek AP, Sabato V, Bridts CH, De Clerck LS, Ebo DG. Immunoglobulin E antibodies to atracurium: a new diagnostic tool? Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2015;45(2):485–7.CrossRef
67.
Laroche D, Chollet-Martin S, Leturgie P, Malzac L, Vergnaud MC, Neukirch C, et al. Evaluation of a new routine diagnostic test for immunoglobulin E sensitization to neuromuscular blocking agents. Anesthesiology. 2011;114(1):91–7.PubMedCrossRef
68.
Leysen J, Bridts CH, De Clerck LS, Vercauteren M, Lambert J, Weyler JJ, et al. Allergy to rocuronium: from clinical suspicion to correct diagnosis. Allergy. 2011;66(8):1014–9.PubMedCrossRef
69.
Leysen J, Uyttebroek A, Sabato V, Bridts CH, De Clerck LS, Ebo DG. Predictive value of allergy tests for neuromuscular blocking agents: tackling an unmet need. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2014;44(8):1069–75.CrossRef
70.
Florvaag E, Johansson SG, Oman H, Harboe T, Nopp A. Pholcodine stimulates a dramatic increase of IgE in IgE-sensitized individuals. A pilot study. Allergy. 2006;61(1):49–55.PubMedCrossRef
71.
Ebo DG, Bridts CH, Hagendorens MM, Mertens CH, De Clerck LS, Stevens WJ. Flow-assisted diagnostic management of anaphylaxis from rocuronium bromide. Allergy. 2006;61(8):935–9.PubMedCrossRef
72.
Uyttebroek AP, Sabato V, Leysen J, Bridts CH, De Clerck LS, Ebo DG. Flowcytometric diagnosis of atracurium-induced anaphylaxis. Allergy. 2014;69(10):1324–32.PubMedCrossRef
73.
Gamboa PM, Sanz ML, Caballero MR, Antepara I, Urrutia I, Jauregui I, et al. Use of CD63 expression as a marker of in vitro basophil activation and leukotriene determination in metamizol allergic patients. Allergy. 2003;58(4):312–7.PubMedCrossRef
74.
Sanz ML, Garcia MC, Caballero MR, Dieguez I, Gamboa PM. Basophil activation test in the diagnosis of allergy to medicines. Anales del sistema sanitario de Navarra. 2003;26(Suppl 2):39–47.PubMed
75.
Gomez E, Blanca-Lopez N, Torres MJ, Requena G, Rondon C, Canto G, et al. Immunoglobulin E-mediated immediate allergic reactions to dipyrone: value of basophil activation test in the identification of patients. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2009;39(8):1217–24.CrossRef
76.
Couto M, Gaspar A, Piedade S, Arede C, Menezes M, Sousa MJ, et al. IgE-mediated metamizol allergy and the usefulness of the cellular allergen stimulation test. Eur Ann Allergy Clin Immunol. 2012;44(3):113–6.PubMed
77.
Hagau N, Longrois D, Petrisor C. Threshold for positivity and optimal dipyrone concentration in flow cytometry-assisted basophil activation test. Allergy Asthma Immunol Res. 2013;5(6):383–8.PubMedPubMedCentralCrossRef
78.
Baldo BA, Pham NH. Histamine-releasing and allergenic properties of opioid analgesic drugs: resolving the two. Anaesth Intensive Care. 2012;40(2):216–35.PubMed
79.
Armentia A, Ruiz-Munoz P, Quesada JM, Postigo I, Herrero M, Martin-Gil FJ, et al. Clinical value of morphine, pholcodine and poppy seed IgE assays in drug-abusers and allergic people. Allergol Immunopathol. 2013;41(1):37–44.CrossRef
80.
Armentia A, Pineda F, Palacios R, Martin-Gil FJ, Miguel AS, Arenal JJ, et al. Utility of opium seed extract tests in preventing hypersensitivity reactions during surgery. Allergol Immunopathol. 2014;42(1):56–63.CrossRef
81.
Van Gasse AL, Hagendorens MM, Sabato V, Bridts CH, De Clerck LS, Ebo DG. IgE to poppy seed and morphine are not useful tools to diagnose opiate allergy. J Allergy Clin Immunol Pract. 2015;3(3):396–9.PubMedCrossRef
82.
Leysen J, De Witte L, Sabato V, Faber M, Hagendorens M, Bridts C, et al. IgE-mediated allergy to pholcodine and cross-reactivity to neuromuscular blocking agents: lessons from flow cytometry. Cytom Part B Clin Cytom. 2013;84(2):65–70.CrossRef
83.
Pinnobphun P, Buranapraditkun S, Kampitak T, Hirankarn N, Klaewsongkram J. The diagnostic value of basophil activation test in patients with an immediate hypersensitivity reaction to radiocontrast media. Ann Allergy Asthma Immunol: Off Publ Am Coll Allergy Asthma Immunol. 2011;106(5):387–93.CrossRef
84.
Philipse E, Sabato V, Bridts C, De Clerck L, Ebo D. Basophil activation in the diagnosis of life-threatening hypersensitivity reaction to iodinated contrast media: a case report. Acta Clin Belg. 2013;68(2):140–2.PubMedCrossRef
85.
Trcka J, Schmidt C, Seitz CS, Brocker EB, Gross GE, Trautmann A. Anaphylaxis to iodinated contrast material: nonallergic hypersensitivity or IgE-mediated allergy? AJR Am J Roentgenol. 2008;190(3):666–70.PubMedCrossRef
86.
Salas M, Gomez F, Fernandez TD, Dona I, Aranda A, Ariza A, et al. Diagnosis of immediate hypersensitivity reactions to radiocontrast media. Allergy. 2013;68(9):1203–6.PubMed
87.
Opstrup MS, Johansen JD, Zachariae C, Garvey LH. Contact allergy to chlorhexidine in a tertiary dermatology clinic in Denmark. Contact Dermat. 2016;74(1):29–36.CrossRef
88.
Ebo DG, Bridts CH, Stevens WJ. IgE-mediated anaphylaxis from chlorhexidine: diagnostic possibilities. Contact Dermat. 2006;55(5):301–2.CrossRef
89.
Faber M, Leysen J, Bridts C, Sabato V, De Clerck LS, Ebo DG. Allergy to chlorhexidine: beware of the central venous catheter. Acta Anaesthesiol Belg. 2012;63(4):191–4.PubMed
90.
Opstrup MS, Malling HJ, Kroigaard M, Mosbech H, Skov PS, Poulsen LK, et al. Standardized testing with chlorhexidine in perioperative allergy—a large single-centre evaluation. Allergy. 2014;69(10):1390–6.PubMedCrossRef
91.
Anderson J, Rose M, Green S, Fernando SL. The utility of specific IgE testing to chlorhexidine in the investigation of perioperative adverse reactions. Ann Allergy Asthma Immunol: Off Publ Am Coll Allergy Asthma Immunol. 2015;114(5):425.e1–426.e1.CrossRef
92.
Ebo DG, Stevens WJ, Bridts CH, Matthieu L. Contact allergic dermatitis and life-threatening anaphylaxis to chlorhexidine. J Allergy Clin Immunol. 1998;101(1 Pt 1):128–9.PubMedCrossRef
93.
Opstrup MS, Poulsen LK, Malling HJ, Jensen BM, Garvey LH. Dynamics of plasma levels of specific IgE in chlorhexidine allergic patients with and without accidental re-exposure. Clin Exp Allergy. 2016;46(8):1090–8.PubMedCrossRef
94.
Ratner B, Crawford LV. The allergenicity of gelatin. Int Arch Allergy Appl Immunol. 1955;6(4–6):370–1.PubMedCrossRef
95.
Mullins RJ, James H, Platts-Mills TA, Commins S. Relationship between red meat allergy and sensitization to gelatin and galactose-alpha-1,3-galactose. J Allergy Clin Immunol. 2012;129(5):1334.e1–1342.e1.CrossRef
96.
Ebo DG, Faber M, Sabato V, Leysen J, Gadisseur A, Bridts CH, et al. Sensitization to the mammalian oligosaccharide galactose-alpha-1,3-galactose (alpha-gal): experience in a Flemish case series. Acta Clin Belg. 2013;68(3):206–9.PubMedCrossRef
97.
Uyttebroek A, Sabato V, Bridts CH, De Clerck LS, Ebo DG. Anaphylaxis to succinylated gelatin in a patient with a meat allergy: galactose-alpha(1, 3)-galactose (alpha-gal) as antigenic determinant. J Clin Anesth. 2014;26(7):574–6.PubMedCrossRef
98.
Chung CH, Mirakhur B, Chan E, Le QT, Berlin J, Morse M, et al. Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose. N Engl J Med. 2008;358(11):1109–17.PubMedPubMedCentralCrossRef
99.
Commins SP, Satinover SM, Hosen J, Mozena J, Borish L, Lewis BD, et al. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-alpha-1,3-galactose. J Allergy Clin Immunol. 2009;123(2):426–33.PubMedCrossRef
100.
Bonadonna P, Pagani M, Aberer W, Bilo MB, Brockow K, Oude Elberink H, et al. Drug hypersensitivity in clonal mast cell disorders: ENDA/EAACI position paper. Allergy. 2015;70(7):755–63.PubMedCrossRef
101.
Akin C. Mast cell activation syndromes presenting as anaphylaxis. Immunol Allergy Clin N Am. 2015;35(2):277–85.CrossRef
102.
Borer-Reinhold M, Haeberli G, Bitzenhofer M, Jandus P, Hausmann O, Fricker M, et al. An increase in serum tryptase even below 11.4 ng/mL may indicate a mast cell-mediated hypersensitivity reaction: a prospective study in Hymenoptera venom allergic patients. Clin Exp Allergy: J Br Soc Allergy. Clin Immunol. 2011;41(12):1777–83.
103.
Garvey LH, Bech B, Mosbech H, Kroigaard M, Belhage B, Husum B, et al. Effect of general anesthesia and orthopedic surgery on serum tryptase. Anesthesiology. 2010;112(5):1184–9.PubMedCrossRef
104.
Sprung J, Weingarten TN, Schwartz LB. Presence or absence of elevated acute total serum tryptase by itself is not a definitive marker for an allergic reaction. Anesthesiology. 2015;122(3):713–4.PubMedCrossRef
105.
De Schryver S, Halbrich M, Clarke A, La Vieille S, Eisman H, Alizadehfar R, et al. Tryptase levels in children presenting with anaphylaxis: temporal trends and associated factors. J Allergy Clin Immunol. 2016;137(4):1138–42.PubMedCrossRef
106.
Alvarez-Twose I, Gonzalez-de-Olano D, Sanchez-Munoz L, Matito A, Jara-Acevedo M, Teodosio C, et al. Validation of the REMA score for predicting mast cell clonality and systemic mastocytosis in patients with systemic mast cell activation symptoms. Int Arch Allergy Immunol. 2012;157(3):275–80.PubMedCrossRef
107.
Mayorga C, Celik G, Rouzaire P, Whitaker P, Bonadonna P, Rodrigues-Cernadas J, et al. In vitro tests for drug hypersensitivity reactions: an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy. 2016;71(8):1103–34.PubMedCrossRef
108.
Fisher MM, Baldo BA. Persistence of allergy to anaesthetic drugs. Anaesth Intensive Care. 1992;20(2):143–6.PubMed
109.
Romano A, Gaeta F, Valluzzi RL, Zaffiro A, Caruso C, Quaratino D. Natural evolution of skin-test sensitivity in patients with IgE-mediated hypersensitivity to cephalosporins. Allergy. 2014;69(6):806–9.PubMedCrossRef
110.
Mangodt EA, Van Gasse AL, Decuyper I, Uyttebroek A, Faber MA, Sabato V, et al. In vitro diagnosis of immediate drug hypersensitivity: should we go with the flow? Int Arch Allergy Immunol. 2015;168(1):3–12.PubMedCrossRef
111.
Sanz ML, Garcia BE, Prieto I, Tabar A, Oehling A. Specific IgE determination in the diagnosis of beta-lactam allergy. J Investig Allergol Clin Immunol. 1996;6(2):89–93.PubMed
112.
Blanca M, Mayorga C, Torres MJ, Reche M, Moya MC, Rodriguez JL, et al. Clinical evaluation of Pharmacia CAP System RAST FEIA amoxicilloyl and benzylpenicilloyl in patients with penicillin allergy. Allergy. 2001;56(9):862–70.PubMedCrossRef
113.
Sanz ML, Gamboa PM, Antepara I, Uasuf C, Vila L, Garcia-Aviles C, et al. Flow cytometric basophil activation test by detection of CD63 expression in patients with immediate-type reactions to betalactam antibiotics. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2002;32(2):277–86.CrossRef
114.
Gamboa PM, Garcia-Aviles MC, Urrutia I, Antepara I, Esparza R, Sanz ML. Basophil activation and sulfidoleukotriene production in patients with immediate allergy to betalactam antibiotics and negative skin tests. J Investig Allergol Clin Immunol. 2004;14(4):278–83.PubMed
115.
Torres MJ, Padial A, Mayorga C, Fernandez T, Sanchez-Sabate E, Cornejo-Garcia JA, et al. The diagnostic interpretation of basophil activation test in immediate allergic reactions to betalactams. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2004;34(11):1768–75.CrossRef
116.
Abuaf N, Rostane H, Rajoely B, Gaouar H, Autegarden JE, Leynadier F, et al. Comparison of two basophil activation markers CD63 and CD203c in the diagnosis of amoxicillin allergy. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2008;38(6):921–8.CrossRef
117.
De Week AL, Sanz ML, Gamboa PM, Aberer W, Sturm G, Bilo MB, et al. Diagnosis of immediate-type beta-lactam allergy in vitro by flow-cytometric basophil activation test and sulfidoleukotriene production: a multicenter study. J Investig Allergol Clin Immunol. 2009;19(2):91–109.PubMed
118.
Eberlein B, Leon Suarez I, Darsow U, Rueff F, Behrendt H, Ring J. A new basophil activation test using CD63 and CCR3 in allergy to antibiotics. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2010;40(3):411–8.CrossRef
119.
Garcia-Ortega P, Marin A. Usefulness of the basophil activation test (BAT) in the diagnosis of life-threatening drug anaphylaxis. Allergy. 2010;65(9):1204.PubMed
120.
Torres MJ, Ariza A, Fernandez J, Moreno E, Laguna JJ, Montanez MI, et al. Role of minor determinants of amoxicillin in the diagnosis of immediate allergic reactions to amoxicillin. Allergy. 2010;65(5):590–6.PubMedCrossRef
121.
Torres MJ, Romano A, Blanca-Lopez N, Dona I, Canto G, Ariza A, et al. Immunoglobulin E-mediated hypersensitivity to amoxicillin: in vivo and in vitro comparative studies between an injectable therapeutic compound and a new commercial compound. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2011;41(11):1595–601.CrossRef
122.
Uyttebroek AP, Sabato V, Cop N, Decuyper II, Faber MA, Bridts CH, et al. Diagnosing cefazolin hypersensitivity: Lessons from dual-labeling flow cytometry. J Allergy Clin Immunol Pract. 2016;4(6):1243–5.PubMedCrossRef
123.
Abuaf N, Rajoely B, Ghazouani E, Levy DA, Pecquet C, Chabane H, et al. Validation of a flow cytometric assay detecting in vitro basophil activation for the diagnosis of muscle relaxant allergy. J Allergy Clin Immunol. 1999;104(2 Pt 1):411–8.PubMedCrossRef
124.
Sudheer PS, Hall JE, Read GF, Rowbottom AW, Williams PE. Flow cytometric investigation of peri-anaesthetic anaphylaxis using CD63 and CD203c. Anaesthesia. 2005;60(3):251–6.PubMedCrossRef
125.
Kvedariene V, Kamey S, Ryckwaert Y, Rongier M, Bousquet J, Demoly P, et al. Diagnosis of neuromuscular blocking agent hypersensitivity reactions using cytofluorimetric analysis of basophils. Allergy. 2006;61(3):311–5.PubMedCrossRef
126.
Sainte-Laudy J, Orsel I. Interest of a new flow cytometric protocol applied to diagnosis and prevention of per anaesthetic accidents induced by neuromuscular blockers. Rev Fr Allergol. 2008;48:5.
127.
Hagau N, Gherman-Ionica N, Sfichi M, Petrisor C. Threshold for basophil activation test positivity in neuromuscular blocking agents hypersensitivity reactions. Allergy Asthma Clin Immunol: Off J Can Soc Allergy Clin Immunol. 2013;9(1):42.CrossRef
128.
Gamboa P, Sanz ML, Caballero MR, Urrutia I, Antepara I, Esparza R, et al. The flow-cytometric determination of basophil activation induced by aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) is useful for in vitro diagnosis of the NSAID hypersensitivity syndrome. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2004;34(9):1448–57.CrossRef
129.
Malbran A, Yeyati E, Rey GL, Galassi N. Diclofenac induces basophil degranulation without increasing CD63 expression in sensitive patients. Clin Exp Immunol. 2007;147(1):99–105.PubMedPubMedCentral
130.
Rodriguez-Trabado A, Camara-Hijon C, Ramos-Cantarino A, Porcel-Carreno SL, Jimenez-Timon S, Pereira-Navarro G, et al. Basophil activation test for the in vitro diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity. Allergy Asthma Proc: Off J Reg State Allergy Soc. 2008;29(3):241–9.CrossRef
131.
Bavbek S, Ikinciogullari A, Dursun AB, Guloglu D, Arikan M, Elhan AH, et al. Upregulation of CD63 or CD203c alone or in combination is not sensitive in the diagnosis of nonsteroidal anti-inflammatory drug intolerance. Int Arch Allergy Immunol. 2009;150(3):261–70.PubMedCrossRef
132.
Celik GE, Schroeder JT, Hamilton RG, Saini SS, Adkinson NF. Effect of in vitro aspirin stimulation on basophils in patients with aspirin-exacerbated respiratory disease. Clin Exp Allergy: J Br Soc Allergy Clin Immunol. 2009;39(10):1522–31.CrossRef
133.
Harrer A, Lang R, Grims R, Braitsch M, Hawranek T, Aberer W, et al. Diclofenac hypersensitivity: antibody responses to the parent drug and relevant metabolites. PLoS One. 2010;5(10):e13707.PubMedPubMedCentralCrossRef
134.
Korosec P, Mavsar N, Bajrovic N, Silar M, Mrhar A, Kosnik M. Basophil responsiveness and clinical picture of acetylsalicylic acid intolerance. Int Arch Allergy Immunol. 2011;155(3):257–62.PubMedCrossRef
135.
Kim MS, Cho YJ. Flow cytometry-assisted basophil activation test as a safe diagnostic tool for aspirin/NSAID hypersenstivity. Allergy Asthma Immunol Res. 2012;4(3):137–42.PubMedPubMedCentralCrossRef
136.
Abuaf N, Rostane H, Barbara J, Toly-Ndour C, Gaouar H, Mathelier-Fusade P, et al. Comparison of CD63 upregulation induced by NSAIDs on basophils and monocytes in patients with NSAID hypersensitivity. J Allergy. 2012;2012:580873.CrossRef
137.
Ariza A, Fernandez TD, Dona I, Aranda A, Blanca-Lopez N, Melendez L, et al. Basophil activation after nonsteroidal anti-inflammatory drugs stimulation in patients with immediate hypersensitivity reactions to these drugs. Cytom Part A: J Int Soc Anal Cytol. 2014;85(5):400–7.CrossRef
Metadata
Title
In Vitro Diagnosis of Immediate Drug Hypersensitivity Anno 2017: Potentials and Limitations
Authors
I. I. Decuyper
E. A. Mangodt
A. L. Van Gasse
K. Claesen
A. Uyttebroek
M. Faber
V. Sabato
C. H. Bridts
C. Mertens
M. M. Hagendorens
L. S. De Clerck
Didier G. Ebo
Publication date
01-06-2017
Publisher
Springer International Publishing
Published in
Drugs in R&D / Issue 2/2017
Print ISSN: 1174-5886
Electronic ISSN: 1179-6901
DOI
https://doi.org/10.1007/s40268-017-0176-x

Other articles of this Issue 2/2017

Drugs in R&D 2/2017 Go to the issue

Review Article

Revisiting CDK Inhibitors for Treatment of Glioblastoma Multiforme

Original Research Article

Canagliflozin as an Initial Therapy in Drug-Naïve Subjects with Type 2 Diabetes Mellitus: A Potential Involvement of Atherogenic Lipids in its Glycemic Efficacy

Original Research Article

Hyperlipidemia Alters the Pharmacokinetics of Posaconazole and Vincristine Upon Co-Administration in Rats

Original Research Article

Solubilization and Stability of Mitomycin C Solutions Prepared for Intravesical Administration

Original Research Article

The Pharmacogenetics of Tacrolimus in Corticosteroid-Sparse Pediatric and Adult Kidney Transplant Recipients

Original Research Article

Psychotropic Drug-Related Fall Incidents in Nursing Home Residents Living in the Eastern Part of The Netherlands