The Basophil Activation Test Is Not a Useful Screening Tool for Hymenoptera Venom-Related Anaphylaxis in Patients with Systemic Mastocytosis

• Published in: International archives of allergy and immunology Vol. 169; no. 2; pp. 125 - 129
• Main Authors: Rietveld, Mark J.A., Schreurs, Marco W.J., Gerth van Wijk, Roy, van Daele, Paul L.A., Hermans, Maud A.W.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland 01.04.2016
• Subjects: Adult; Aged; Allergens - immunology; Anaphylaxis - complications; Anaphylaxis - diagnosis; Anaphylaxis - immunology; Animals; Antibody Specificity - immunology; Arthropod Venoms - immunology; Basophils - immunology; Basophils - metabolism; Female; Humans; Hymenoptera - immunology; Immunoglobulin E - blood; Immunoglobulin E - immunology; Insect Bites and Stings; Male; Mastocytosis, Systemic - complications; Middle Aged; Original Paper; Hymenoptera; Basophil activation; Systemic mastocytosis
• ISSN: 1018-2438; 1423-0097
• DOI: 10.1159/000444996

Background: Systemic mastocytosis (SM) patients are at a high risk for anaphylaxis, with Hymenoptera as the main culprit. A screening instrument to identify which patients are sensitized to Hymenoptera before they experience anaphylaxis would therefore be of great value. The basophil activation test (BAT) is proposed as a possible tool for diagnosing Hymenoptera venom-related allergy (HVA), especially in patients in whom conventional allergy tests yield contradictory results. Methods: We included outpatients with SM, according to WHO criteria, from September 2011 to January 2012. Next, to obtain various clinical data including intradermal test results, specific immunoglobulin E (sIgE) measurements and BAT were performed. Results: We included 29 patients, 9 of whom had a history of HVA and 4 of whom had experienced anaphylaxis due to other triggers. Sixteen patients had no history of anaphylaxis. sIgE was detected in 6 patients with HVA and in 2 patients with anaphylaxis due to other triggers. The BAT was positive in only 1 patient, in whom the skin test and sIgE were also positive. Compared to patients with skin lesions, those without skin lesions had significantly more anaphylaxis and sIgE to Hymenoptera. During a 3-year follow-up, no one experienced new anaphylactic episodes. Conclusion: The BAT is not a reliable tool for randomly screening SM patients for HVA.