Basophil activation test and lymphocyte transformation test in cefuroxime-induced anaphylactic reactions
IntroductionCefuroxime allergy may present as a delayed-type reaction or as an immunoglobulin (Ig)E-mediated immediate-type anaphylactic reaction. The basophil activation test (BAT) is a diagnostic tool for cefuroxime-induced immediate-type reactions, whereas the lymphocyte transformation test (LTT)...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Allergy |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/falgy.2025.1532775/full |
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| author | Andreas Glässner Diana Dubrall Diana Dubrall Gerda Wurpts Gerda Wurpts Philipp Deck Günther Weindl Caspar A. Heubach Amir S. Yazdi Amir S. Yazdi Bernhardt Sachs Bernhardt Sachs |
| author_facet | Andreas Glässner Diana Dubrall Diana Dubrall Gerda Wurpts Gerda Wurpts Philipp Deck Günther Weindl Caspar A. Heubach Amir S. Yazdi Amir S. Yazdi Bernhardt Sachs Bernhardt Sachs |
| author_sort | Andreas Glässner |
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| description | IntroductionCefuroxime allergy may present as a delayed-type reaction or as an immunoglobulin (Ig)E-mediated immediate-type anaphylactic reaction. The basophil activation test (BAT) is a diagnostic tool for cefuroxime-induced immediate-type reactions, whereas the lymphocyte transformation test (LTT) is typically applied in delayed-type drug allergy. This study aimed to compare the results of the BAT and LTT in 15 patients with cefuroxime-induced anaphylactic reactions considered as confirmed. The pharmacoepidemiological part aimed to analyze spontaneous reports of cefuroxime-associated anaphylactic reactions in the European adverse drug reaction database (EudraVigilance).MethodsIn EudraVigilance, 668 reports of cefuroxime-associated anaphylactic reactions for the European Economic Area (EEA) between 2010 and 2023 were analyzed, with 182 (27.2%) of these reports originating from Germany. The BAT and the LTT were performed according to standard protocols. Except for one patient, all BAT were performed prior to the skin tests, whereas all LTT were performed thereafter.ResultsAlmost all reports were classified as serious (EEA, 99.3%; Germany, 98.9%). In 60.8% (EEA) and 66.9% (Germany) of reports with respective information, the reaction occurred after intravenous administration. BAT was performed in 12 of 15 patients (3/12 positive; sensitivity 25%), while LTT was performed in all 15 patients (7/15 positive; sensitivity 46.7%).ConclusionsOur analysis highlights the importance of cefuroxime-associated anaphylactic reactions, as almost all of the spontaneous reports were classified as serious. Neither a negative BAT nor LTT can rule out a sensitization in cefuroxime-induced anaphylactic reactions. |
| format | Article |
| id | doaj-art-b0ded0e931da4a4491512e90e72e3866 |
| institution | Kabale University |
| issn | 2673-6101 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Allergy |
| spelling | doaj-art-b0ded0e931da4a4491512e90e72e38662025-08-20T03:42:03ZengFrontiers Media S.A.Frontiers in Allergy2673-61012025-03-01610.3389/falgy.2025.15327751532775Basophil activation test and lymphocyte transformation test in cefuroxime-induced anaphylactic reactionsAndreas Glässner0Diana Dubrall1Diana Dubrall2Gerda Wurpts3Gerda Wurpts4Philipp Deck5Günther Weindl6Caspar A. Heubach7Amir S. Yazdi8Amir S. Yazdi9Bernhardt Sachs10Bernhardt Sachs11Research Division, Federal Institute for Drugs and Medical Devices (BfArM), Bonn, GermanyResearch Division, Federal Institute for Drugs and Medical Devices (BfArM), Bonn, GermanyInstitute for Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, GermanyDepartment of Dermatology and Allergology, RWTH University Hospital Aachen, Aachen, GermanyAachen Comprehensive Allergy Center (ACAC), University Hospital Aachen, Aachen, GermanyPharmacology and Toxicology, Pharmaceutical Institute, University of Bonn, Bonn, GermanyPharmacology and Toxicology, Pharmaceutical Institute, University of Bonn, Bonn, GermanyResearch Division, Federal Institute for Drugs and Medical Devices (BfArM), Bonn, GermanyDepartment of Dermatology and Allergology, RWTH University Hospital Aachen, Aachen, GermanyAachen Comprehensive Allergy Center (ACAC), University Hospital Aachen, Aachen, GermanyResearch Division, Federal Institute for Drugs and Medical Devices (BfArM), Bonn, GermanyDepartment of Dermatology and Allergology, RWTH University Hospital Aachen, Aachen, GermanyIntroductionCefuroxime allergy may present as a delayed-type reaction or as an immunoglobulin (Ig)E-mediated immediate-type anaphylactic reaction. The basophil activation test (BAT) is a diagnostic tool for cefuroxime-induced immediate-type reactions, whereas the lymphocyte transformation test (LTT) is typically applied in delayed-type drug allergy. This study aimed to compare the results of the BAT and LTT in 15 patients with cefuroxime-induced anaphylactic reactions considered as confirmed. The pharmacoepidemiological part aimed to analyze spontaneous reports of cefuroxime-associated anaphylactic reactions in the European adverse drug reaction database (EudraVigilance).MethodsIn EudraVigilance, 668 reports of cefuroxime-associated anaphylactic reactions for the European Economic Area (EEA) between 2010 and 2023 were analyzed, with 182 (27.2%) of these reports originating from Germany. The BAT and the LTT were performed according to standard protocols. Except for one patient, all BAT were performed prior to the skin tests, whereas all LTT were performed thereafter.ResultsAlmost all reports were classified as serious (EEA, 99.3%; Germany, 98.9%). In 60.8% (EEA) and 66.9% (Germany) of reports with respective information, the reaction occurred after intravenous administration. BAT was performed in 12 of 15 patients (3/12 positive; sensitivity 25%), while LTT was performed in all 15 patients (7/15 positive; sensitivity 46.7%).ConclusionsOur analysis highlights the importance of cefuroxime-associated anaphylactic reactions, as almost all of the spontaneous reports were classified as serious. Neither a negative BAT nor LTT can rule out a sensitization in cefuroxime-induced anaphylactic reactions.https://www.frontiersin.org/articles/10.3389/falgy.2025.1532775/fullcefuroximeanaphylactic reactionlymphocyte transformation testbasophil activation testspontaneous reports |
| spellingShingle | Andreas Glässner Diana Dubrall Diana Dubrall Gerda Wurpts Gerda Wurpts Philipp Deck Günther Weindl Caspar A. Heubach Amir S. Yazdi Amir S. Yazdi Bernhardt Sachs Bernhardt Sachs Basophil activation test and lymphocyte transformation test in cefuroxime-induced anaphylactic reactions Frontiers in Allergy cefuroxime anaphylactic reaction lymphocyte transformation test basophil activation test spontaneous reports |
| title | Basophil activation test and lymphocyte transformation test in cefuroxime-induced anaphylactic reactions |
| title_full | Basophil activation test and lymphocyte transformation test in cefuroxime-induced anaphylactic reactions |
| title_fullStr | Basophil activation test and lymphocyte transformation test in cefuroxime-induced anaphylactic reactions |
| title_full_unstemmed | Basophil activation test and lymphocyte transformation test in cefuroxime-induced anaphylactic reactions |
| title_short | Basophil activation test and lymphocyte transformation test in cefuroxime-induced anaphylactic reactions |
| title_sort | basophil activation test and lymphocyte transformation test in cefuroxime induced anaphylactic reactions |
| topic | cefuroxime anaphylactic reaction lymphocyte transformation test basophil activation test spontaneous reports |
| url | https://www.frontiersin.org/articles/10.3389/falgy.2025.1532775/full |
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