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Minimal agreement between basophil activation test and immunoassay in diagnosis of penicillin allergy

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dc.contributor.authorB. Leecyous
dc.contributor.authorF. Bakhtiar
dc.contributor.authorM.M. Tang
dc.contributor.authorZ.H.M. Yadzir
dc.contributor.authorN. Abdullah
dc.date.accessioned2024-07-23T04:16:18Z
dc.date.available2024-07-23T04:16:18Z
dc.date.issued2020
dc.description.abstractIntroduction Basophil activation test (BAT) and immunoassays are the most widely used in vitro tests to diagnose IgE-mediated allergic reactions to penicillin. However, studies to determine if one test is interdependent from another are limited. Objective The present study aimed to measure the agreement between BAT and immunoassay in diagnosis of penicillin allergy. Method BAT was performed using penicillin G (Pen G), penicillin V (Pen V), penicilloyl-polylysine (PPL), minor determinant mix (MDM), amoxicillin (Amx) and ampicillin (Amp) in 25 patients. Immunoassay of total IgE (tIgE) and specific IgE (sIgE) antibodies to Pen G, Pen V, Amx and Amp were quantified. Skin prick test (SPT) using PPL-MDM, Amx, Amp and Clavulanic acid were also performed. Results Minimal agreement was observed between BAT and immunoassay (k = 0.25). Of two BAT-positive patients, one patient is positive to Amx (59.27%, SI = 59) and Amp (82.32%, SI = 82) but sIgE-negative to all drug tested. This patient is also SPT-positive to both drugs. Another patient is BAT-positive to Pen G (10.18%, SI = 40), Pen V (25.07%, SI = 100) and Amp (19.52%, SI = 79). In sIgE immunoassay, four patients were sIgE-positive to at least one of the drugs tested. The sIgE level of three patients was between low and moderate and they were BAT-negative. One BAT-positive patient had a high level of sIgE antibodies (3.50–17.5 kU/L) along with relatively high specific to total IgE ratio ≥0.002 (0.004–0.007). Conclusions The agreement between BAT and immunoassay is minimal. Performing both tests provides little increase in the sensitivity of allergy diagnosis work-up for immediate reactions to penicillin.
dc.identifier.doihttps://doi.org/10.1016/j.aller.2020.01.006
dc.identifier.urihttps://www.sciencedirect.com/science/article/abs/pii/S0301054620300793
dc.identifier.urihttps://repository.nih.gov.my/handle/123456789/705
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofAllergologia et Immunopathologia
dc.relation.issn0301-0546
dc.relation.journalAllergologia et Immunopathologia
dc.subjectBasophil
dc.subjectImmunoassay
dc.subjectPenicillin
dc.titleMinimal agreement between basophil activation test and immunoassay in diagnosis of penicillin allergy
dc.typejournal-article
dspace.entity.typePublication
oaire.citation.issue6
oaire.citation.volume48
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