ReviewDrugs in R&D2017
In Vitro Diagnosis of Immediate Drug Hypersensitivity Anno 2017: Potentials and Limitations.
Review in Drugs in R&D, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Hypersensitivity reactions to contrast media: Part 2. Prevention of recurrent hypersensitivity reactions in adults. Updated guidelines by the ESUR Contrast Media Safety Committee.European radiology · 2025Guideline
- Mutations ofThe journal of allergy and clinical immunology. Global · 2025Review
- IgE clonality and aggregation of insulin affect IgE-mediated activation of sensitized basophils.The journal of allergy and clinical immunology. Global · 2025Article
- Applications of basophil activation test in paediatric allergic diseases.The World Allergy Organization journal · 2024Review
- Drug hypersensitivity reactions: review of the state of the science for prediction and diagnosis.Toxicological sciences : an official journal of the Society of Toxicology · 2024Review
- Allergic and other adverse reactions to drugs used in anesthesia and surgery.Anesthesiology and perioperative science · 2023Review
- Review
- MRGPRX2 and Adverse Drug Reactions.Frontiers in immunology · 2021Review
- Measurement and Functional Analysis of the Mas-Related G Protein-Coupled Receptor MRGPRX2 on Human Mast Cells and Basophils.Methods in molecular biology (Clifton, N.J.) · 2020Article
- Basophil Activation as Marker of Clinically Relevant Allergy and Therapy Outcome.Frontiers in immunology · 2020Review
- Rocuronium-induced anaphylaxis: a case report.JA clinical reports · 2019Article
- BAT in the Diagnosis of Drug Allergy: a Novel Tool in Clinical Daily Practice?Current allergy and asthma reports · 2019Review
- Pediatric drug hypersensitivity: which diagnostic tests?Acta bio-medica : Atenei Parmensis · 2019Review
- The role of basophils as innate immune regulatory cells in allergy and immunotherapy.Human vaccines & immunotherapeutics · 2018Review
- Mas-Related G Protein-Coupled Receptor-X2 (MRGPRX2) in Drug Hypersensitivity Reactions.Frontiers in immunology · 2018Article
- Update on Quinolone Allergy.Current allergy and asthma reports · 2017Review
- [Update on perioperative hypersensitivity reactions: joint document from the Brazilian Society of Anesthesiology (SBA) and Brazilian Association of Allergy and Immunology (ASBAI) - Part II: etiology and diagnosis].Brazilian journal of anesthesiology (Elsevier)Review
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor most physicians, quantification of drug-specific immunoglobulin E (drug-sIgE) antibodies constitutes the primary in vitro measure to document immediate drug hypersensitivity reactions (IDHR). Unfortunately, this is often insufficient to correctly identify patients with IgE-mediated IDHR and impossible for non-IgE-mediated IDHR that result from alternative routes of basophil and mast cell activation. In these difficult cases, diagnosis might benefit from cellular tests such as basophil activation tests (BAT).
aimThe aim was to review the potential and limitations of quantification of sIgE and BAT in diagnosing IDHR. The utility of quantification of serum tryptase is discussed.
methodsA literature search was conducted using the key words allergy, basophil activation, CD63, CD203c, diagnosis, drugs, hypersensitivity, flow cytometry, specific IgE antibodies; this was complemented by the authors' own experience.
resultsThe drugs that have been most studied with both techniques are β-lactam antibiotics and curarizing neuromuscular blocking agents (NMBA). For sIgE morphine, data are available on the value of this test as a biomarker for sensitization to substituted ammonium structures that constitute the major epitope of NMBA, especially rocuronium and suxamethonium. For the BAT, there are also data on non-steroidal anti-inflammatory drugs (NSAIDs) and iodinated radiocontrast media. For β-lactam antibiotics, sensitivity and specificity of sIgE varies between 0 and 85% and 52 and 100%, respectively. For NMBA, sensitivity and specificity varies between 38.5 and 92% and 85.7 and 100%, respectively. Specific IgE to morphine should not be used in isolation to diagnose IDHR to NMBA nor opiates. For the BAT, sensitivity generally varies between 50 and 60%, whereas specificity attains 80%, except for quinolones and NSAIDs.
conclusionsAlthough drug-sIgE assays and BAT can provide useful information in the diagnosis of IDHR, their predictive value is not absolute. Large-scale collaborative studies are mandatory to harmonize and optimize test protocols and to establish drug-specific decision thresholds.
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