Advertisement

BAT in the Diagnosis of Drug Allergy: a Novel Tool in Clinical Daily Practice?

  • Lucila CamposEmail author
  • Violeta Régnier Galvão
  • Jorge Kalil
  • Mariana Castells
  • Pedro Giavina-Bianchi
Anaphylaxis and Drug Allergy (David A. Khan & Mariana Castells, Section Editors)
  • 45 Downloads
Part of the following topical collections:
  1. Topical Collection on Anaphylaxis and Drug Allergy

Abstract

Purpose of Review

The aim of this study is to critically review the relevant literature published on basophil activation test, presenting the current knowledge and future perspectives.

Recent Findings

Basophil activation test (BAT) results varied accordingly to the class of the drug studied, and have promising results in immediate hypersensitivity reactions to pyrazolone (selective reactors), neuromuscular blockers, beta-lactams, and platinum compounds, all examples of classical IgE-mediated hypersensitivity drug reactions.

Summary

Currently, BAT is applied in research settings, but based in the results of our review, the test can be considered as a diagnostic tool for daily practice for selected patients and selected drugs, when the test is available, particularly for patients who experienced severe reactions and when diagnosis cannot be stablished by serum-specific IgE and skin testing, in order to avoid unnecessary drug provocations tests.

Keywords

Basophil activation test BAT Hypersensitivity reactions Drug allergy 

Notes

Statement of Contribution

All authors meet the three conditions:

(1) Substantial contributions to conception of the study

(2) Drafting the article and revising it critically for important intellectual content

(3) Final approval of the version to be published

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

I confirm that this paper has been read and approved by all the co-authors, and that no conflicts of interest exist regarding its publication.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Hunziker T, Bruppacher R, Kuenzi UP, Maibach R, Braunschweig S, Halter F, et al. Classification of ADRs: a proposal for harmonization and differentiation based on the experience of the comprehensive hospital drug monitoring Bern/St. Gallen, 1974-1993. Pharmacoepidemiol Drug Saf. 2002;11(2):159–63.CrossRefGoogle Scholar
  2. 2.
    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.CrossRefGoogle Scholar
  3. 3.
    •• Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, et al. International consensus on drug allergy. Allergy. 2014;69(4):420–37. Most updated and cited consensus in drug allergy. CrossRefGoogle Scholar
  4. 4.
    •• Brockow K, Garvey LH, Aberer W, Atanaskovic-Markovic M, Barbaud A, Bilo MB, et al. Skin test concentrations for systemically administered drugs -- an ENDA/EAACI drug allergy interest group position paper. Allergy. 2013;68(6):702–12. Most complete expert pannel regarding immediate skin test standardization. CrossRefGoogle Scholar
  5. 5.
    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.CrossRefGoogle Scholar
  6. 6.
    Torres MJ, Romano A, Blanca-Lopez N, Doña 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. 2011;41(11):1595–601.CrossRefGoogle Scholar
  7. 7.
    Steiner M, Harrer A, Lang R, Schneider M, Ferreira T, Hawranek T, et al. Basophil activation test for investigation of IgE-mediated mechanisms in drug hypersensitivity. J Vis Exp. 2011;(55):1–7.Google Scholar
  8. 8.
    •• Giavina-Bianchi P, Galvao VR, Picard M, Caiado J, Castells MC. Basophil activation test is a relevant biomarker of the outcome of rapid desensitization in platinum compounds-allergy. J Allergy Clin Immunol Pract. 2017;5(3):728–36. Main case series studying BAT in platinum compound allergy. CrossRefGoogle Scholar
  9. 9.
    • Iwamoto T, Yuta A, Tabata T, Sugimoto H, Gabazza EC, Hirai H, et al. Evaluation of basophil CD203c as a predictor of carboplatin-related hypersensitivity reaction in patients with gynecologic cancer. Biol Pharm Bull. 2012;35(9):1487–95. Study showing a positive predective value of BAT in platinum compound allergy. CrossRefGoogle Scholar
  10. 10.
    Chinuki Y, Kaneko S, Dekio I, Takahashi H, Tokuda R, Nagao M, et al. CD203c expression-based basophil activation test for diagnosis of wheat-dependent exercise-induced anaphylaxis. J Allergy Clin Immunol. 2012;129(5):1404–6.CrossRefGoogle Scholar
  11. 11.
    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.CrossRefGoogle Scholar
  12. 12.
    Doña I, Blanca-López N, Torres MJ, García-Campos J, García-Núñez I, Gómez F, et al. Drug hypersensitivity reactions: response patterns, drug involved, and temporal variations in a large series of patients. J Investig Allergol Clin Immunol. 2012;22(5):363–71.PubMedGoogle Scholar
  13. 13.
    Aun MV, Blanca M, Garro LS, Ribeiro MR, Kalil J, Motta AA, et al. Nonsteroidal anti-inflammatory drugs are major causes of drug-induced anaphylaxis. J Allergy Clin Immunol Pract. 2014;2(4):414–20.CrossRefGoogle Scholar
  14. 14.
    Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, et al. International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol. 2018;8(2):108–352.CrossRefGoogle Scholar
  15. 15.
    •• Gómez 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. 2009;39(8):1217–24. Large case series studying BAT in selective immediate reactions to dipyrone. CrossRefGoogle Scholar
  16. 16.
    Dona I, Barrionuevo E, Salas M, Cornejo-Garcia JA, Perkins JR, Bogas G, et al. Natural evolution in patients with nonsteroidal anti-inflammatory drug-induced urticaria/angioedema. Allergy. 2017;72(9):1346–55.CrossRefGoogle Scholar
  17. 17.
    Aun MV, Kalil J, Giavina-Bianchi P. Drug-induced anaphylaxis. Immunol Allergy Clin N Am. 2017;37(4):629–41.CrossRefGoogle Scholar
  18. 18.
    Ebo DG, Faber M, Elst J, Van Gasse AL, Bridts CH, Mertens C, et al. In Vitro diagnosis of immediate drug hypersensitivity during anesthesia: a review of the literature. J Allergy Clin Immunol Pract. 2018;6(4):1176–84.Google Scholar
  19. 19.
    Decuyper II, Mangodt EA, Van Gasse AL, Claesen K, Uyttebroek A, Faber M, et al. In vitro diagnosis of immediate drug hypersensitivity anno 2017: potentials and limitations. Drugs R D. 2017;17(2):265–78.CrossRefGoogle Scholar
  20. 20.
    • Kowalski ML, Makowska JS, Blanca M, Bavbek S, Bochenek G, Bousquet J, et al. Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA(#) and GA2LEN/HANNA*. Allergy. 2011;66(7):818–29. Enlightening consensus of hypersensitivity to nonsteroidal anti-inflammatory drugs. CrossRefGoogle Scholar
  21. 21.
    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.CrossRefGoogle Scholar
  22. 22.
    Gamboa PM, Sanz ML, Caballero MR, Antépara I, Urrutia I, Jáuregui 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.CrossRefGoogle Scholar
  23. 23.
    Blanca-López N, Pérez-Sánchez N, Agúndez JA, García-Martin E, Torres MJ, Cornejo-García JA, et al. Allergic reactions to metamizole: immediate and delayed responses. Int Arch Allergy Immunol. 2016;169(4):223–30.CrossRefGoogle Scholar
  24. 24.
    • Ariza A, García-Martín E, Salas M, Montañez MI, Mayorga C, Blanca-Lopez N, et al. Pyrazolones metabolites are relevant for identifying selective anaphylaxis to metamizole. Sci Rep. 2016;6:23845. Study showing the relevance of metabolites in pyrazolone allergy. CrossRefGoogle Scholar
  25. 25.
    Bavbek S, Ikincioğullari A, Dursun AB, Guloğlu 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.CrossRefGoogle Scholar
  26. 26.
    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.CrossRefGoogle Scholar
  27. 27.
    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. 2009;39(10):1522–31.CrossRefGoogle Scholar
  28. 28.
    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.CrossRefGoogle Scholar
  29. 29.
    • 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. Study that provides insights on the mechanisms involved in diclofenac immediate hypersensitivity reactions. PubMedPubMedCentralGoogle Scholar
  30. 30.
    Dvorak AM. Degranulation and recovery from degranulation of basophils and mast cells. Chem Immunol Allergy. 2005;85:205–51.CrossRefGoogle Scholar
  31. 31.
    Dvorak AM. Piecemeal degranulation of basophils and mast cells is effected by vesicular transport of stored secretory granule contents. Chem Immunol Allergy. 2005;85:135–84.CrossRefGoogle Scholar
  32. 32.
    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 (Cairo). 2012;2012:580873.Google Scholar
  33. 33.
    •• Gamboa P, Sanz ML, Caballero MR, Urrutia I, Antépara 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. 2004;34(9):1448–57. Large case series studying BAT in immediate hypersensitivity reactions to NSAIDs. CrossRefGoogle Scholar
  34. 34.
    Sanz ML, Gamboa P, de Weck AL. A new combined test with flowcytometric basophil activation and determination of sulfidoleukotrienes is useful for in vitro diagnosis of hypersensitivity to aspirin and other nonsteroidal anti-inflammatory drugs. Int Arch Allergy Immunol. 2005;136(1):58–72.CrossRefGoogle Scholar
  35. 35.
    •• De Weck AL, Sanz ML, Gamboa PM, Jermann JM, Kowalski M, Medrala W, et al. Nonsteroidal anti-inflammatory drug hypersensitivity syndrome: a multicenter study. II. Basophil activation by nonsteroidal anti-inflammatory drugs and its impact on pathogenesis. J Investig Allergol Clin Immunol. 2010;20(1):39–57. Large case series studying BAT in immediate hypersensitivity reactions to NSAIDs. PubMedGoogle Scholar
  36. 36.
    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. 2008;29(3):241–9.CrossRefGoogle Scholar
  37. 37.
    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. 2002;102(2):192–9.CrossRefGoogle Scholar
  38. 38.
    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.CrossRefGoogle Scholar
  39. 39.
    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.CrossRefGoogle Scholar
  40. 40.
    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.CrossRefGoogle Scholar
  41. 41.
    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.CrossRefGoogle Scholar
  42. 42.
    •• 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. 2014;44(8):1069–75. Large case series studying BAT in immediate hypersensitivity reactions to neuromuscular blocking agent. CrossRefGoogle Scholar
  43. 43.
    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. 2013;9(1):42.CrossRefGoogle Scholar
  44. 44.
    Decuyper II, Ebo DG, Uyttebroek AP, Hagendorens MM, Faber MA, Bridts CH, et al. Quantification of specific IgE antibodies in immediate drug hypersensitivity: more shortcomings than potentials? Clin Chim Acta. 2016;460:184–9.CrossRefGoogle Scholar
  45. 45.
    •• 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. Large case series studying BAT in immediate hypersensitivity reactions to neuromuscular blocking agent. CrossRefGoogle Scholar
  46. 46.
    Dewachter P, Chollet-Martin S, Mouton-Faivre C, de Chaisemartin L, Nicaise-Roland P. Comparison of basophil activation test and skin testing performances in NMBA allergy. J Allergy Clin Immunol Pract. 2018;6(5):1681–89.Google Scholar
  47. 47.
    Gomes ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol. 2005;5(4):309–16.CrossRefGoogle Scholar
  48. 48.
    Barni S, Mori F, Valleriani C, Mangone G, Testi S, Saretta F, et al. The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults. Ital J Pediatr. 2017;43(1):42.CrossRefGoogle Scholar
  49. 49.
    Doña I, Torres MJ, Montañez MI, Fernández TD. In vitro diagnostic testing for antibiotic allergy. Allergy Asthma Immunol Res. 2017;9(4):288–98.CrossRefGoogle Scholar
  50. 50.
    Sanz ML, Gamboa PM, Antépara I, Uasuf C, Vila L, Garcia-Avilés 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. 2002;32(2):277–86.CrossRefGoogle Scholar
  51. 51.
    Eberlein B, León Suárez I, Darsow U, Ruëff F, Behrendt H, Ring J. A new basophil activation test using CD63 and CCR3 in allergy to antibiotics. Clin Exp Allergy. 2010;40(3):411–8.CrossRefGoogle Scholar
  52. 52.
    Torres MJ, Padial A, Mayorga C, Fernández T, Sanchez-Sabate E, Cornejo-García JA, et al. The diagnostic interpretation of basophil activation test in immediate allergic reactions to betalactams. Clin Exp Allergy. 2004;34(11):1768–75.CrossRefGoogle Scholar
  53. 53.
    Gamboa PM, García-Avilés MC, Urrutia I, Antépara 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.PubMedGoogle Scholar
  54. 54.
    •• 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. Large case series studying BAT in immediate hypersensitivity reactions to beta-lactams. PubMedGoogle Scholar
  55. 55.
    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. 2008;38(6):921–8.CrossRefGoogle Scholar
  56. 56.
    García-Ortega P, Marín A. Usefulness of the basophil activation test (BAT) in the diagnosis of life-threatening drug anaphylaxis. Allergy. 2010;65(9):1204.PubMedGoogle Scholar
  57. 57.
    Torres MJ, Ariza A, Fernández J, Moreno E, Laguna JJ, Montañez MI, et al. Role of minor determinants of amoxicillin in the diagnosis of immediate allergic reactions to amoxicillin. Allergy. 2010;65(5):590–6.CrossRefGoogle Scholar
  58. 58.
    Thinnes A, Merk HF, Wurpts G, Röseler S, Lehmann S, Tenbrock K, et al. Individual risk assessment in the diagnosis of immediate type drug hypersensitivity reactions to betalactam and non-betalactam antibiotics using basophil activation test: a single center experience. Cutan Ocul Toxicol. 2018;37(4):309–18.Google Scholar
  59. 59.
    •• Salas M, Fernández-Santamaría R, Mayorga C, Barrionuevo E, Ariza A, Posadas T, et al. Use of the basophil activation test may reduce the need for drug provocation in amoxicillin-clavulanic allergy. J Allergy Clin Immunol Pract. 2018;6(3):1010–8.e2. Large case series studying BAT in amoxicillin-clavulanic allergy. CrossRefGoogle Scholar
  60. 60.
    Doña I, Moreno E, Pérez-Sánchez N, Andreu I, Hernández Fernandez de Rojas D, Torres MJ. Update on quinolone allergy. Curr Allergy Asthma Rep. 2017;17(8):56.CrossRefGoogle Scholar
  61. 61.
    Lobera T, Audícana MT, Alarcón E, Longo N, Navarro B, Muñoz D. Allergy to quinolones: low cross-reactivity to levofloxacin. J Investig Allergol Clin Immunol. 2010;20(7):607–11.PubMedGoogle Scholar
  62. 62.
    Aranda A, Mayorga C, Ariza A, Doña I, Rosado A, Blanca-Lopez N, et al. In vitro evaluation of IgE-mediated hypersensitivity reactions to quinolones. Allergy. 2011;66(2):247–54.CrossRefGoogle Scholar
  63. 63.
    Rouzaire P, Nosbaum A, Denis L, Bienvenu F, Bérard 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.CrossRefGoogle Scholar
  64. 64.
    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.CrossRefGoogle Scholar
  65. 65.
    Mayorga C, Andreu I, Aranda A, Doña I, Montañez MI, Blanca-Lopez N, et al. Fluoroquinolone photodegradation influences specific basophil activation. Int Arch Allergy Immunol. 2013;160(4):377–82.CrossRefGoogle Scholar
  66. 66.
    Blanca-López N, Ariza A, Doña I, Mayorga C, Montañez MI, Garcia-Campos J, et al. Hypersensitivity reactions to fluoroquinolones: analysis of the factors involved. Clin Exp Allergy. 2013;43(5):560–7.CrossRefGoogle Scholar
  67. 67.
    Demir S, Gelincik A, Akdeniz N, Aktas-Cetin E, Olgac M, Unal D, et al. Usefulness of in vivo and in vitro diagnostic tests in the diagnosis of hypersensitivity reactions to quinolones and in the evaluation of cross-reactivity: a comprehensive study including the latest quinolone gemifloxacin. Allergy Asthma Immunol Res. 2017;9(4):347–59.CrossRefGoogle Scholar
  68. 68.
    Seitz CS, Bröcker EB, Trautmann A. Diagnostic testing in suspected fluoroquinolone hypersensitivity. Clin Exp Allergy. 2009;39(11):1738–45.CrossRefGoogle Scholar
  69. 69.
    Fernández TD, Ariza A, Palomares F, Montañez MI, Salas M, Martín-Serrano A, et al. Hypersensitivity to fluoroquinolones: the expression of basophil activation markers depends on the clinical entity and the culprit fluoroquinolone. Medicine (Baltimore). 2016;95(23):e3679.CrossRefGoogle Scholar
  70. 70.
    Iwamoto T, Hirai H, Yamaguchi N, Kobayashi N, Sugimoto H, Tabata T, et al. Carboplatin-induced severe hypersensitivity reaction: role of IgE-dependent basophil activation and FcεRI. Cancer Sci. 2014;105(11):1472–9.CrossRefGoogle Scholar
  71. 71.
    Viardot-Helmer A, Ott H, Sauer I, Merk HF. Basophil activation test as in vitro assay for cisplatin allergy. Hautarzt. 2008;59(11):883–4.CrossRefGoogle Scholar
  72. 72.
    de la Varga Martínez R, Gutiérrez Fernández D, Foncubierta Fernández A, Andrés García JA, Medina Varo F. Rapid subcutaneous desensitization for treatment of hypersensitivity reactions to etanercept in two patients with positive basophil activation test. Allergol Int. 2017;66(2):357–9.CrossRefGoogle Scholar
  73. 73.
    González-de-Olano D, Morgado JM, Juárez-Guerrero R, Sánchez-Muñoz L, Letellez-Fernández J, Malón-Giménez D, et al. Positive basophil activation test following anaphylaxis to pertuzumab and successful treatment with rapid desensitization. J Allergy Clin Immunol Pract. 2016;4(2):338–40.CrossRefGoogle Scholar
  74. 74.
    • Piva E, Chieco-Bianchi F, Krajcar V, Aversa S, Plebani M. Adverse reactions in patients with B-cell lymphomas during combined treatment with rituximab: in vitro evaluation of rituximab hypersensitivity by basophil activation test. Am J Hematol. 2012;87(11):E130–1. Case series studying BAT in immediate hypersensitivity reactions to rituximab. CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Lucila Campos
    • 1
    Email author
  • Violeta Régnier Galvão
    • 1
  • Jorge Kalil
    • 1
  • Mariana Castells
    • 2
    • 3
    • 4
    • 5
  • Pedro Giavina-Bianchi
    • 1
  1. 1.Clinical Immunology and Allergy DivisionUniversity of São PauloSão PauloBrazil
  2. 2.Harvard medical SchoolBostonUSA
  3. 3.Adverse Drug Reactions and Desesitization ProgramBrigham and Women’s HospitalBostonUSA
  4. 4.Allergy and Immunology Training Program, department of MedicineBrigham and Women’s HospitalBostonUSA
  5. 5.Division of Rheumatology, Allergy and Immunology, Department of MedicineBrigham and Women’s HospitalBostonUSA

Personalised recommendations