title: Clinical routine utility of basophil activation testing for diagnosis of hymenoptera-allergic patients with emphasis on individuals with negative venom-specific IgE antibodies.
abstract: BACKGROUND
  Previous reports suggest the usefulness of basophil activation testing (BAT) in Hymenoptera-allergic patients with negative venom-specific IgE antibodies. We sought to evaluate the diagnostic utility of this testing in a routine clinical laboratory setting.
  
  
  METHODS
  Twenty-one patients with anaphylactic reactions to Hymenoptera sting (median grade III) and negative venom-specific IgE were routinely and prospectively tested with BAT.
  
  
  RESULTS
  We were able to diagnose 81% (17 of 21) of patients with BAT and 57% (12 of 21) with intradermal skin testing. Three wasp venom-allergic patients showed IgE positivity to rVes v 5. Four patients (19%) were negative for all tests. In the case of double-positive BAT, the culprit insect correlated with the venom that induced a significantly higher basophil response.
  
  
  CONCLUSIONS
  BAT allows the identification of severe Hymenoptera-allergic patients with negative specific IgE and skin tests. The routine use of this cellular test should facilitate prescription of venom immunotherapy in complex cases with inconclusive diagnostic results.
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia. peter.korosec@klinika-golnik.si
authors.forename: Peter
authors.initials: P
authors.lastname: Korošec
authors.forename: Mira
authors.initials: M
authors.lastname: Šilar
authors.forename: Renato
authors.initials: R
authors.lastname: Eržen
authors.forename: Nina
authors.initials: N
authors.lastname: Čelesnik
authors.forename: Nissera
authors.initials: N
authors.lastname: Bajrović
authors.forename: Mihaela
authors.initials: M
authors.lastname: Zidarn
authors.forename: Mitja
authors.initials: M
authors.lastname: Košnik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control*; D000818:Animals; D015549:Basophil Degranulation Test / Q000379:methods*; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D007299:Insect Bites and Stings / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000276:immunology; D014688:Venoms / Q000276:immunology; D055815:Young Adult
chemical_list: D000485:Allergens; D011994:Recombinant Proteins; D014688:Venoms; C431905:Ves v 5 allergen; D007073:Immunoglobulin E