Concordance between history of drug allergy and diagnostic tests in an allergoanaesthesia centre

Natalia Hagău¹, I. Alb¹, Liliana Bene², Simona Cocu¹, Nadia Gherman-Ionică³, Cristina Indrei¹

1 ATI II, Universitatea de Medicină şi Farmacie „Iuliu Haţieganu” Cluj-Napoca
2 Laborator Imunologie, Spitalul Judeţean de Urgenţă Cluj
3 Alergologie, Universitatea de Medicină şi Farmacie „Iuliu Haţieganu” Cluj-Napoca

Abstract

Objectives. We designed the present study in order to estimate the concordance between history of drug allergy and diagnostic tests in patients with mild and severe symptoms and to determine the appropriate time for testing.

Material and methods. We tested 65 culprit drugs for 57 patients. We performed in vivo and in vitro tests according to the international recommendations.

Results. From the mild allergic reactions, 19.23% were confirmed in vivo, 34.62% in vitro and 46.15% using all tests. From the severe ones, 33.33% were confirmed in vivo, 58.97% in vitro and 71.79% using all tests. The concordance between the history of the severe reactions and diagnostic tests was significantly higher when all tests were combined (46.15% vs. 71.79%, p = 0.04). Flow cytometry was positive in 35.13% of the allergies under 2 years and 3.57% of the allergies over 2 years (p = 0.0017 < 0.05).

Conclusions. In our study, the concordance with history is higher when tests are used together. In patients with severe reactions the positive results are the most frequent. The diagnostic value of the basophil activation test seems to be higher when the lapse of time between the allergic reaction and testing is short.

Keywords: drug allergy, skin test, basophil activation test

J Rom Anest Terap Int 2010; 17: 29-33

STUDII CLINICE

Concordanţa între istoricul de alergie medicamentoasă şi testele alergologice într-un centru de alergoanestezie