The Basophil Activation Test Can Be of Value for Diagnosing Immediate Allergic Reactions to Omeprazole
Autor: | Jose Julio Laguna, Javier Dionicio, Adriana Ariza, Isabel Olazabal, Rosario Gonzalez-Mendiola, Tahia D. Fernandez, María José Torres, Ruben Fernandez-Santamaria, Inmaculada Doña, Cristobalina Mayorga, Gador Bogas, Maria Salas |
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Rok vydání: | 2017 |
Předmět: |
0301 basic medicine
Adult Hypersensitivity Immediate Male medicine.medical_specialty medicine.drug_class Provocation test Lansoprazole Proton-pump inhibitor Basophil Degranulation Test Gastroenterology Sensitivity and Specificity Drug Hypersensitivity 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Immunology and Allergy Humans Pyrophosphatases Omeprazole Pantoprazole CD63 business.industry Phosphoric Diester Hydrolases Tetraspanin 30 Incidence (epidemiology) Proton Pump Inhibitors Allergens Middle Aged Basophils Basophil activation 030104 developmental biology 030228 respiratory system Female business medicine.drug |
Zdroj: | The journal of allergy and clinical immunology. In practice. 6(5) |
ISSN: | 2213-2201 |
Popis: | Background Proton pump inhibitors (PPIs) are commonly used to treat gastrointestinal diseases. Incidence of hypersensitivity reactions to PPIs has risen, likely because of increased consumption. Their diagnosis is difficult, with skin tests (STs) presenting low sensitivity, making it necessary to perform drug provocation tests (DPTs). The value of in vitro tests for the diagnosis of immediate reaction to PPI is unclear. Objective To analyze the diagnostic value of the basophil activation test (BAT) in a group of patients diagnosed with immediate allergy to omeprazole. Methods The study included 42 patients with confirmed immediate allergic reactions to omeprazole confirmed by positive ST results or DPT results and 22 age- and sex-matched subjects tolerant to PPIs. BAT was performed with omeprazole, pantoprazole, and lansoprazole using CD63 and CD203c as activation markers. Results ST sensitivity was 66.7% with a specificity of 100%. BAT using CD63 with a stimulation index of more than 2 as positive revealed a sensitivity of 73.8%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 66.7%. BAT was positive in 57.1% of patients with negative ST result, and thus by combining ST and BAT we can correctly diagnose 85.7% of patients with immediate allergy to omeprazole. Conclusion BAT represents a complementary tool for inclusion in the allergological workup for patients allergic to omeprazole. When combined with ST, it can be of value to guide the clinician as to whether to perform a DPT. |
Databáze: | OpenAIRE |
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