Diagnostic value of the basophil activation test in evaluating Hymenoptera venom sensitization.
BACKGROUND
Diagnosis of allergy to Hymenoptera venom is usually confirmed with skin testing and measurement of specific serum IgE antibody, tests which are sometimes inconclusive. In these cases, additional in vitro tests are necessary. The aim of this study was to show the applicability of the basophil activation test in detecting sensitization to Hymenoptera venom and to compare the test sensitivity and clinical positive-predictive value with skin prick tests and measurement of allergen-specific serum IgE.


METHODS
This prospective study was conducted between June 2004 and December 2007 and included a large group of 204 patients. All patients had a history of at least one systemic allergic reaction of Müller grades II-IV after a Hymenoptera sting. We compared results of the basophil activation test, specific serum IgE and skin prick tests with patients' clinical history and data on culprit insects.


RESULTS
The overall clinical sensitivities of the basophil activation test, specific serum IgE and skin prick tests were 90%, 76% and 64%, respectively; the clinical positive-predictive values of the three tests were 79%, 73% and 78% for bee venom, 86%, 59% and 43% for wasp venom; and 84%, 77% and 22% for both venoms.


CONCLUSIONS
Our results revealed a higher clinical sensitivity and comparable or better clinical positive-predictive value of basophil activation tests than skin prick tests and allergen-specific serum IgE in the detection of allergy to Hymenoptera venom.
Peternelj
Andreja
A
University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia. andreja.mr_peternelj@klinika-golnik.si
Silar
Mira
M
Bajrovic
Nissera
N
Adamic
Katja
K
Music
Ema
E
Kosnik
Mitja
M
Korosec
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D015549:Basophil Degranulation Test; D001514:Bee Venoms / Q000276:immunology*; D001733:Bites and Stings / Q000276:immunology*; D000939:Epitopes / Q000276:immunology; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D006967:Hypersensitivity / Q000175:diagnosis / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood; D007428:Intradermal Tests; D008297:Male; D008407:Mast Cells / Q000276:immunology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014862:Wasp Venoms / Q000276:immunology*; D055815:Young Adult
D001514:Bee Venoms; D000939:Epitopes; D014862:Wasp Venoms; D007073:Immunoglobulin E