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Basophil activation test in the diagnosis and monitoring of mastocytosis patients with wasp venom allergy on immunotherapy

Bidad, K., Nawijn, M., van Oosterhout, A. J. M., van der Heide, S. & Oude Elberink, H. N. G., May-2014, In : Cytometry. Part B: Clinical Cytometry. 86, 3, p. 183-190 8 p.

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  • Basophil activation test in the diagnosis and monitoring of mastocytosis

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Background

There is need for an accurate diagnostic test in mastocytosis patients with wasp venom allergy (WVA) and monitoring of these patients during immunotherapy (IT). In this study, we aimed to evaluate sensitivity and specificity of the Basophil Activation Test (BAT) as a diagnostic and monitoring test in patients with mastocytosis and WVA.

Methods

Seventeen patients with mastocytosis and WVA and six mastocytosis patients without WVA were included. BAT was performed before the start of IT (first visit) and at 6 weeks (second visit) and 1 year (third visit), after reaching the maintenance dose. Of 17 patients included, 11 completed the third visit. In mastocytosis patients with WVA, dose-dependent wasp-venom induced upregulation of CD63 and CD203c expression on basophils was observed compared with mastocytosis patients without WVA. Serum specific IgE, IgG4, and tryptase levels were measured in all patients.

Results

BAT had a sensitivity of 87% and specificity of 100% in diagnosing WVA in mastocytosis patients. Basophil allergen threshold sensitivity with respect to CD63 and CD203c was significantly decreased in the second visit compared with the first visit and increased significantly in the third visit compared with the second visit. Specific IgE levels increased significantly in the second visit compared with first and decreased significantly in the third visit compared with the second. Specific IgG4 levels rose significantly in the second visit compared with the first and on the third visit compared with the second. Tryptase levels did not change significantly during the study.

Conclusions

BAT represents a diagnostic test with 100% specificity in allergic patients with mastocytosis and these patients are better to be monitored for a longer period during IT. (c) 2013 International Clinical Cytometry Society

Original languageEnglish
Pages (from-to)183-190
Number of pages8
JournalCytometry. Part B: Clinical Cytometry
Volume86
Issue number3
Publication statusPublished - May-2014

    Keywords

  • basophil activation test, immunotherapy, wasp venom allergy, mastocytosis, HYMENOPTERA VENOM, FLOW-CYTOMETRY, THRESHOLD-SENSITIVITY, RUSH IMMUNOTHERAPY, FOLLOW-UP, ANAPHYLAXIS, HISTAMINE, RELEASE, STINGS, CRITERIA

ID: 13208637