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Document Details :

Title: Een patiënt met ernstige hypotensie tijdens algemene narcose
Author(s): EBO DG, STEVENS WJ
Journal: Tijdschrift voor Geneeskunde
Volume: 58    Issue: 16   Date: 2002   
Pages: 1021-1023
DOI: 10.2143/TVG.58.16.5001397

Abstract :
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Flow cytometric analysis of in vitro activated basophils for the diagnosis of muscle relaxant allergy
Anaphylactic reactions during anaesthesia are mainly the result of muscle-relaxants, anaesthetics, analgesics and natural rubber latex. Skin tests, quantification of serum IgE against quaternary ammonium-bearing molecules, e.g. suxamethonium, and in vitro basophil histamine release are used to investigate muscle-relaxant allergy. However, the predictive value of these tests is relatively low.
Basophils activated with specific allergen which is recognised by surface receptor FceRI-bound IgE, not only secrete and generate quantifiable bioactive mediators, but also up-regulate the expression of certain markers (e.g., CD45 and CD63) which can be detected by multicolour flow cytometry. In resting basophils CD63 is anchored in the basophilic granule membrane and only weakly expressed on the surface membrane (generally less than 5% in healthy controls). In contrast, as a result of fusion between the granule and plasma membrane, CD63 is expressed with a high density on activated basophils and mirrors histamine release.
We describe a patient with esmeron allergy in which diagnosis could be established by the assay which we named the basophil activation test (BAT).

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