Immunoglobulin E-mediated immediate allergic reactions to dipyrone: value of basophil activation test in the identification of patients.

Abstract

BACKGROUND:

Pyrazolones are a major cause of immediate IgE-mediated reactions to drugs in many countries.

OBJECTIVE:

The aim of the study was to evaluate a group of patients with this type of reaction by basophil activation test (BAT), focusing on the influence on positivity of the time between the reaction and this study.

METHODS:

The study included 51 patients with selective immediate allergic reactions to pyrazolones and 56 controls. Patients were defined by skin testing or a drug provocation test and BATs with pyrazolones were carried out in all cases. Patients who were BAT positive were followed-up for 30 months to establish the rate of decline in positive tests.

RESULTS:

BAT was positive in 28 (54.9%) cases. BAT sensitivity was higher in those who were skin-test positive (85.7%) compared with those who were skin-test negative (33.3%). The time between the initial reaction and this study was significantly shorter in those who were skin-test positive (P=0.005) and those who were BAT positive (P=0.017). Follow-up of the BAT-positive patients showed a decrease over time, with 60% of these patients becoming negative after 6 months.

CONCLUSIONS:

BAT is a useful complement to skin testing for the evaluation of immediate allergic reactions to pyrazolones. Although not optimal, BAT sensitivity was also positive in patients with a negative skin test and it is a reasonable alternative in patients with severe reactions who may develop symptoms after skin testing. The time of performance of the test is critical to obtain a positive response.

• Authors: E Gómez, N Blanca-Lopez, M J Torres, G Requena, C Rondon, G Canto, M Blanca, C Mayorga
• Journal: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (Clin Exp Allergy) Vol. 39 Issue 8 Pg. 1217-24 (Aug 2009) ISSN: 1365-2222 [Electronic] England
• PMID: 19400910 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Immunoglobulin E
• Dipyrone

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects, immunology)
• Basophil Degranulation Test (methods)
• Basophils (immunology)
• Dipyrone (adverse effects, immunology)
• Drug Hypersensitivity (diagnosis, immunology)
• Female
• Flow Cytometry
• Humans
• Hypersensitivity, Immediate (diagnosis, immunology)
• Immunoglobulin E (blood, immunology)
• Male
• Middle Aged
• Sensitivity and Specificity
• Skin Tests
• Time Factors
• Young Adult