NSAID HYPERSENSITIVITY AND BASOPHIL ACTIVATION TEST

  • Jorge Viana Assistente de Imunoalergologia/Consultant, Immunology and Allergology, Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra
  • Sofia Vale Pereira Investigadora do Instituto de Patologia Geral/Investigator atf the Institute of General Pathology, Faculdade de Medicina, Universidade de Coimbra
  • Carlos Loureiro Assistente Hospitalar Graduado/Graduated Consultant, Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra
  • Anabela Mota Pinto Professora Catedrática de Fisiopatologia/Professor of Physiopathology, da Faculdade de Medicina da Universidade de Coimbra; Diretora do Instituto de Patologia Geral/Head of the Institute of General Pathology, Faculdade de Medicina, Universidade de Coimbra
  • Ana Todo-Bom Diretora de Serviço/Head of the Department, Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Keywords: Anti-inflammatory agents, Non-steroidal, adverse effects, Basophil degranulation test, Drug hypersensitivity, diagnosis, Urticaria, complications, Drug provocation test

Abstract

Introduction: Allergy to nonsteroidal anti-inflammatory drugs (NSAIDs) is often associated with severe hypersensitivity reactions and with difficult diagnosis. Basophil activation test by flow cytometry with Flow2cast (BAT) is a novel in vitro test for identification of hypersensitivity reactions to these drugs but with some limitations.

Clinical case: Young male manifesting chronic urticaria since childhood presented with worsening of hives with angioedema immediately after NSAID intake. Last reaction happened over a year before after lysine acetylsalicylate. Initial BAT for diagnosis with acetylsalicylic acid (ASA) was inconclusive. Drug provocation test (DPT) negative to celecoxib. Another DPT with 700mg of ASA triggered anaphylaxis three hours later with hypoxia and serum tryptase 27.1μg / L. A second BAT had higher basal activation and marked increase with ASA incubation.

Discussion: This case shows current BAT recommendation in NSAID hypersensitivity: a negative BAT does not avoid NSAID DPT. However, time between last reaction and BAT seems to influence results.

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How to Cite
Viana, J., Vale Pereira, S., Loureiro, C., Mota Pinto, A., & Todo-Bom, A. (1). NSAID HYPERSENSITIVITY AND BASOPHIL ACTIVATION TEST. Journal of the Portuguese Society of Dermatology and Venereology, 73(2), 293-298. https://doi.org/10.29021/spdv.73.2.380
Section
Case Reports