Flow Cytometry-Assisted Basophil Activation Test as a Safe Diagnostic Tool for Aspirin/NSAID Hypersenstivity.
10.4168/aair.2012.4.3.137
- Author:
Myung Shin KIM
1
;
Young Joo CHO
Author Information
1. Department of Internal Medicine, Soon Chun Hyang University Gumi Hospital, Gumi, Korea.
- Publication Type:Original Article
- Keywords:
Flow cytometry;
basophil;
aspirin;
non-steroidal anti-inflammatory drugs;
drug hypersensitivity
- MeSH:
Antibodies, Anti-Idiotypic;
Aspirin;
Basophils;
Diagnostic Tests, Routine;
Diclofenac;
Drug Hypersensitivity;
Female;
Flow Cytometry;
Humans;
Hypersensitivity;
Ibuprofen;
Prevalence
- From:Allergy, Asthma & Immunology Research
2012;4(3):137-142
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Aspirin and non-steroidal anti-inflammatory drugs (ASA/NSAIDs) are common causes of drug hypersensitivity. An oral provocation test is the only definitive diagnostic test. This study assessed the reliability of a flow cytometry-assisted basophil activation test (FAST) as a safe diagnostic method for ASA/NSAID-induced hypersensitivity, as its high sensitivity and specificity have been demonstrated for many other drugs. METHODS: Eighteen patients and 11 controls were enrolled. Using a Flow-CAST kit(R) (Buhlmann Laboratories AG, Schonenbuch, Switzerland), 29 analyses with aspirin, ibuprofen, and diclofenac were performed by flow cytometry to detect double-positive staining of anti-IgE and anti-CD63. The stimulation index was defined as the activated basophil percentage after drug stimulation/basally active basophil percentage. A stimulation index> or =2 and an absolute activated basophil percentage> or =5 were considered positive. RESULTS: Patients with hypersensitivity to ASA/NSAIDs were predominantly female, and the prevalence of atopy was higher in patients than in controls. A sensitivity of 61%, specificity of 91%, positive predictive value of 92%, and negative predictive value of 59% were achieved. CONCLUSIONS: FAST is a useful additional method for diagnosis of hypersensitivity reactions to ASA/NSAIDs. Further development is required to increase the sensitivity of the test.
