• Panwas Pinnobphun, Supranee Buranapraditkun, Thatchai Kampitak, Nattiya Hirankarn, and Jettanong Klaewsongkram.
• Medical Microbiology, Interdisciplinary Program, Graduate School Chulalongkorn University, Bangkok, Thailand.
• Ann. Allergy Asthma Immunol. 2011 May 1; 106 (5): 387-93.

BackgroundNo available test diagnoses allergic reactions to radiocontrast media (RCM). The basophil activation test (BAT) has been introduced for the diagnosis of both immunoglobulin (Ig) E and non-IgE-dependent mast cell degranulation, but its value to diagnose immediate RCM reactions is still unknown.ObjectiveThis study aims to evaluate the diagnostic value of BAT in immediate RCM hypersensitivity.MethodsThe BATs were performed in 26 patients with immediate RCM reactions and in 43 specimens from healthy volunteers. The sample's whole blood was incubated with the responsible RCM and % activated (CD63+/CCR3+) basophils were analyzed by flow cytometry. Receiver operating characteristics (ROC) curve analysis was performed to calculate the optimal cutoff value of activated basophils to diagnose patients with RCM hypersensitivity.ResultsThe incubation of blood with RCM yielded significantly higher activated basophil percentages in patients with a history of immediate RCM reactions than in normal controls with both 1:100 and 1:10 dilutions (13.11% vs. 2.71%, P value = .01; and 19.23% vs. 3.73%, P = .001, respectively). Both % activated basophils and stimulation index (SI) had acceptable discrimination powers to diagnose RCM hypersensitivity. The area under the curve was 0.79 (95% CI 0.67-0.91, P = .000) by using SI as the diagnostic criteria with 1:100 dilution of RCM. The specificity of the test ranged from 88.4% to 100%.ConclusionOur study demonstrated the potential of BAT as a diagnostic tool for an immediate RCM hypersensitivity, particularly as a confirmation test. Further studies are required to confirm the test accuracy and identify a patient's predisposing factors.Copyright © 2011. Published by Elsevier Inc.

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