Method: Nineteen patients with a drug-induced anaphylaxis were recruited. Basophil activation test, skin tests, and measurement of commercially available specific IgE to drugs were performed for diagnostic evaluation. A stimulation index≥2 and an absolute activated basophil percentage≥5 were considered positive response to BAT.
Results: All patients met the FAAN/NIAID criteria for anaphylaxis. Causality assessment using the WHO-UMC classified them into the categories ‘certain’ or ‘probable’. Male to female ratio was 1:1.1 and the mean age was 46.0 ± 12.0 yrs. Five patients presented severe anaphyalxis such as hypotension, hypoxia or loss of consciousness, and the others were moderate severity. The involved drugs were cephalosporin antibiotics in 9 patients, eperisone 2, ranitidine 3, and aminoglycoside, glimepiride, humalog insulin, paclitaxel, tradamol, propofol in one patient each. BAT using CD 63 marker was positive in 12 (63.2%), and negative in 7 patients, whereas BAT using CD203c was positive in 9 (47.4%) and negative in 10 patients. When both markers applied, 14 patients (70.0%) showed positive to BAT. Skin test was positive in 8 (47.0%), negative in 9, and nonapplicable in two patients.
Conclusion: The BAT proves to be a useful diagnostic tool for drug-induced anaphyalxis. In addition, this test can identify the causative drug in patients with negative skin test or unavailable to sIgE measurement.