title: Negativity of the basophil activation test in quinolone hypersensitivity: a breakthrough for provocation test decision-making.
abstract: BACKGROUND
  Quinolone hypersensitivity reactions are being more frequently reported. Skin tests in investigations of patients are known to not be fully reliable. The provocation test thus remains the gold standard in the definitive diagnosis of allergy, despite the risks involved. The aim of this study was to evaluate basophil activation tests (BATs) in the diagnosis of immediate-type reactions to quinolones.
  
  
  METHODS
  Thirty-four patients who presented an immediate-type hypersensivity reaction less than an hour after quinolone administration were studied. The allergologic workup of these patients consisted of a careful clinical history, a skin test and a BAT with the culprit quinolone. If not contraindicated, and in the case of high probability of a nonallergic reaction, provocation tests were performed to assess the nonimmunologic nature of the hypersensitivity.
  
  
  RESULTS
  Among the 34 patients studied, 17 (50%) presented a negative BAT to the suspected quinolone, while the other 17 (50%) patients presented a positive BAT for quinolone at the time of their reaction. Among the 17 patients with negative BATs, 15 (2 of whom had had positive skin tests) had quinolone successfully reintroduced.
  
  
  CONCLUSIONS
  Our report suggests that the BAT, if negative for the culprit quinolone, is a valuable tool in the decision whether or not to perform provocation tests in patients with a history of immediate-type reaction to quinolones, in order to exclude an allergic reaction.
authors: Immunology Laboratory, CHU Lyon-Sud, Pierre Bénite, France. paul.rouzaire@chu-lyon.fr
authors: Paul
authors: P
authors: Rouzaire
authors: Audrey
authors: A
authors: Nosbaum
authors: Laure
authors: L
authors: Denis
authors: Françoise
authors: F
authors: Bienvenu
authors: Frédéric
authors: F
authors: Bérard
authors: Grégoire
authors: G
authors: Cozon
authors: Jacques
authors: J
authors: Bienvenu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D015549:Basophil Degranulation Test; D003661:Decision Support Techniques; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015363:Quinolones / Q000009:adverse effects*; D016037:Single-Blind Method; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones