Diagnosis of neuromuscular blocking agent hypersensitivity reactions using cytofluorimetric analysis of basophils.
BACKGROUND
Immunoglobulin E (IgE)-mediated hypersensitivity reactions to neuromuscular blocking agents (NMBA) are common and life threatening. Basophil activation based upon the expression of CD63 in the presence of specific allergens was found to be of importance for the diagnosis of IgE-mediated hypersensibility.


METHODS
The Basotest was evaluated for the diagnosis of NMBA in 47 patients with proven NMBA anaphylaxis, 40 atopic subjects nonallergic to NMBA and five healthy volunteers. Diagnosis of NMBA was made according to international standards on clinical history, skin tests and provocation tests when needed.


RESULTS
In the NMBA allergic patients, sensitivity of Basotest was 36.1%, but it increased to 85.7% for reactions which occurred within the last 3 years. The specificity was 93.3%.


CONCLUSIONS
Basotest may be useful for the diagnosis of NMBA allergy in patients with a suspicion of recent IgE-mediated hypersensitivity reaction to NMBA.
Kvedariene
V
V
INSERM U454-IFR3, Hôpital Arnaud de Villeneuve, Montpellier Cedex, France.
Kamey
S
S
Ryckwaert
Y
Y
Rongier
M
M
Bousquet
J
J
Demoly
P
P
Arnoux
B
B
D000328:Adult; D015549:Basophil Degranulation Test / Q000379:methods*; D016022:Case-Control Studies; D015331:Cohort Studies; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005470:Fluorometry; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects* / Q000627:therapeutic use; D012016:Reference Values; D012680:Sensitivity and Specificity
D009466:Neuromuscular Blocking Agents