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2017 ; 43
(1
): 42
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The utility of the basophil activation test in the diagnosis of immediate
amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults
#MMPMID28431585
Barni S
; Mori F
; Valleriani C
; Mangone G
; Testi S
; Saretta F
; Sarti L
; Pucci N
; de Martino M
; Azzari C
; Novembre E
Ital J Pediatr
2017[Apr]; 43
(1
): 42
PMID28431585
show ga
BACKGROUND: The basophil activation test (BAT), has been proposed as a possible
assay for the diagnosis of immediate-type allergy to beta-lactams (BLs). The aim
of this study was to assess the utility of BAT in the diagnosis of amoxicillin
(AMX) or AMX-clavulanate (AMX-C) IgE-mediated hypersensitivity in children and
adults. MATERIAL AND METHODS: Eighteen children and 21 adults, with clinical
history of immediate reactions to AMX or AMX-C, were referred to Anna Meyer
Children's Hospital and San Giovanni di Dio Hospital, respectively. They
underwent in vivo tests (skin prick test and intradermal test). Moreover, BAT
with AMX or AMX-C was performed within 6 months from the reaction. RESULTS: In
the pediatric group, the concordance between the skin tests (ST) and BAT results
was 83.3%. Upon comparing the symptom grades and ST results to the BAT results,
we found that the reaction severity and ST positivity did not correlate with BAT
results in children. In the adult group, the concordance between the ST and BAT
results was 61.9%. Upon comparing patients with severe reactions and patients
with mild reactions in terms of BAT results, we found a BAT sensitivity of 38.5%
and a specificity of 100%. When comparing the symptom grades to the BAT results,
we found that no patients with mild symptoms had a positive BAT result, whereas
38.5% of patients with severe symptoms had a positive BAT result. CONCLUSIONS:
BAT does not seem to be a useful tool to increase the sensitivity of an allergy
work-up to diagnose immediate hypersensitivity to AMX or AMX-C.