title: Flow Cytometry-Assisted Basophil Activation Test as a Safe Diagnostic Tool for Aspirin/NSAID Hypersenstivity.
abstract: OBJECTIVE
  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® (Bühlmann Laboratories AG, Schönenbuch, 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≥2 and an absolute activated basophil percentage≥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.
authors.affiliation: Department of Internal Medicine, Soon Chun Hyang University Gumi Hospital, Gumi, Korea.
authors.forename: Myung Shin
authors.initials: MS
authors.lastname: Kim
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Cho