Author/Editor | Korošec, P; Eržen, R; Šilar, M; Bajrović, N; Kopač, P; Košnik, M | |
Title | Basophil responsiveness in patients with insect sting allergies and negative venom-specific immunoglobulin E and skin prick test results | |
Type | članek | |
Source | Clin Exp Allergy | |
Vol. and No. | Letnik 39, št. 11 | |
Publication year | 2009 | |
Volume | str. 1730-7 | |
Language | eng | |
Abstract | Background: Current guidelines do not adequately address the question of how best to manage patients with a convincing history of insect allergy, but negative venom-specific IgE and skin test results. Methods: Forty-seven patients out of a total of 1219 (4%), with a positive history of sting allergy, were recruited over a period of 4.5 years. All recruited patients had a convincing history of a severe or a life-threatening anaphylactic reaction of Mueller grade II-IV (median grade III) after Hymenoptera sting, but negative venom-specific IgE and skin prick test results. Diagnostic work-up was prospectively followed by the CD63 basophil activation test and by intradermal skin testing. A control group of 25 subjects was also assessed. Results: Thirty-five out of 47 (75%) patients demonstrated a positive basophil CD63 response after stimulation with bee and/or wasp venom. Intradermal venom skin tests were performed for 37 patients, 17 (46%) of whom showed positive results. Out of 20 patients who demonstrated negative intradermal test results, 12 patients showed a positive CD63 response (60%). In contrast, out of 9 patients who showed a negative CD63 response, only one was detected by intradermal testing (11%). In the control group, only two out of 25 (4%) subjects displayed a positive basophil response and/or intradermal test. Conclusion: Here we show that, in complex cases with inconclusive diagnostic results, the CD63 activation test could be particularly useful and more sensitive than intradermal skin testing. | |
Descriptors | INSECT BITES AND STINGS ANAPHYLAXIS BASOPHILS BEE VENOMS WASP VENOMS IGE INTRADERMAL TESTS |