Introduction

Basophil activation test (BAT) and immunoassays are the most widely used in vitro tests to diagnose IgE-mediated allergic reactions to penicillin. However, studies to determine if one test is interdependent from another are limited.

Objective

The present study aimed to measure the agreement between BAT and immunoassay in diagnosis of penicillin allergy.

Method

BAT was performed using penicillin G (Pen G), penicillin V (Pen V), penicilloyl-polylysine (PPL), minor determinant mix (MDM), amoxicillin (Amx) and ampicillin (Amp) in 25 patients. Immunoassay of total IgE (tIgE) and specific IgE (sIgE) antibodies to Pen G, Pen V, Amx and Amp were quantified. Skin prick test (SPT) using PPL-MDM, Amx, Amp and Clavulanic acid were also performed.

Results

Minimal agreement was observed between BAT and immunoassay (k = 0.25). Of two BAT-positive patients, one patient is positive to Amx (59.27%, SI = 59) and Amp (82.32%, SI = 82) but sIgE-negative to all drug tested. This patient is also SPT-positive to both drugs. Another patient is BAT-positive to Pen G (10.18%, SI = 40), Pen V (25.07%, SI = 100) and Amp (19.52%, SI = 79). In sIgE immunoassay, four patients were sIgE-positive to at least one of the drugs tested. The sIgE level of three patients was between low and moderate and they were BAT-negative. One BAT-positive patient had a high level of sIgE antibodies (3.50–17.5 kU/L) along with relatively high specific to total IgE ratio ≥0.002 (0.004–0.007).

Conclusions

The agreement between BAT and immunoassay is minimal. Performing both tests provides little increase in the sensitivity of allergy diagnosis work-up for immediate reactions to penicillin.

中文翻译：

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嗜碱性粒细胞活化试验和免疫测定在青霉素过敏诊断中的最小一致性。

介绍

嗜碱性粒细胞活化试验 (BAT) 和免疫测定是诊断 IgE 介导的青霉素过敏反应最广泛使用的体外试验。然而，确定一项测试是否相互依赖的研究是有限的。

客观的

本研究旨在测量 BAT 和免疫测定在青霉素过敏诊断中的一致性。

方法

25 名患者使用青霉素 G (Pen G)、青霉素 V (Pen V)、青霉素-聚赖氨酸 (PPL)、次要决定簇混合物 (MDM)、阿莫西林 (Amx) 和氨苄青霉素 (Amp) 进行 BAT。对 Pen G、Pen V、Amx 和 Amp 的总 IgE (tIgE) 和特异性 IgE (sIgE) 抗体的免疫测定进行了定量。还进行了使用 PPL-MDM、Amx、Amp 和克拉维酸的皮肤点刺试验 (SPT)。

结果

在 BAT 和免疫测定之间观察到最小的一致性 ( k  = 0.25)。在两名 BAT 阳性患者中，一名患者对 Amx (59.27%, SI = 59) 和 Amp (82.32%, SI = 82) 呈阳性，但对所有测试的药物均为 sIgE 阴性。该患者对两种药物也是 SPT 阳性。另一名患者对 Pen G (10.18%, SI = 40)、Pen V (25.07%, SI = 100) 和 Amp (19.52%, SI = 79) 呈 BAT 阳性。在 sIgE 免疫测定中，四名患者对至少一种测试药物呈 sIgE 阳性。三名患者的 sIgE 水平介于低和中之间，并且他们是 BAT 阴性。一名 BAT 阳性患者具有高水平的 sIgE 抗体 (3.50–17.5 kU/L)，同时对总 IgE 比率≥0.002 (0.004–0.007) 的特异性相对较高。

结论

BAT 和免疫测定之间的一致性很小。执行这两项测试几乎不会增加过敏诊断检查对青霉素立即反应的敏感性。