title: The Basophil Activation Test Is Not a Useful Screening Tool for Hymenoptera Venom-Related Anaphylaxis in Patients with Systemic Mastocytosis.
abstract: BACKGROUND
  Systemic mastocytosis (SM) patients are at a high risk for anaphylaxis, with Hymenoptera as the main culprit. A screening instrument to identify which patients are sensitized to Hymenoptera before they experience anaphylaxis would therefore be of great value. The basophil activation test (BAT) is proposed as a possible tool for diagnosing Hymenoptera venom-related allergy (HVA), especially in patients in whom conventional allergy tests yield contradictory results.
  
  
  METHODS
  We included outpatients with SM, according to WHO criteria, from September 2011 to January 2012. Next, to obtain various clinical data including intradermal test results, specific immunoglobulin E (sIgE) measurements and BAT were performed.
  
  
  RESULTS
  We included 29 patients, 9 of whom had a history of HVA and 4 of whom had experienced anaphylaxis due to other triggers. Sixteen patients had no history of anaphylaxis. sIgE was detected in 6 patients with HVA and in 2 patients with anaphylaxis due to other triggers. The BAT was positive in only 1 patient, in whom the skin test and sIgE were also positive. Compared to patients with skin lesions, those without skin lesions had significantly more anaphylaxis and sIgE to Hymenoptera. During a 3-year follow-up, no one experienced new anaphylactic episodes.
  
  
  CONCLUSIONS
  The BAT is not a reliable tool for randomly screening SM patients for HVA.
authors.affiliation: Section of Clinical Immunology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Mark J A
authors.initials: MJ
authors.lastname: Rietveld
authors.forename: Marco W J
authors.initials: MW
authors.lastname: Schreurs
authors.forename: Roy
authors.initials: R
authors.lastname: Gerth van Wijk
authors.forename: Paul L A
authors.initials: PL
authors.lastname: van Daele
authors.forename: Maud A W
authors.initials: MA
authors.lastname: Hermans
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D000707:Anaphylaxis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*; D000818:Animals; D000918:Antibody Specificity / Q000276:immunology; D001180:Arthropod Venoms / Q000276:immunology*; D001491:Basophils / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007299:Insect Bites and Stings; D008297:Male; D034721:Mastocytosis, Systemic / Q000150:complications*; D008875:Middle Aged
chemical_list: D000485:Allergens; D001180:Arthropod Venoms; D007073:Immunoglobulin E