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In Vitro Diagnosis of Immediate Allergic Reactions to Drugs: An Update


C Mayorga,1 ML Sanz,2 PM Gamboa,3 BE García,4 on behalf of the Clinical Immunology Committee of the Spanish Society of Allergology and Clinical Immunology of the SEAIC (MT Caballero, JM García, M Labrador, C Lahoz, N Longo Areso, M López Hoyos, J Martínez Quesada, FJ Monteseirín)

1Research Laboratory, Fundación IMABIS - Carlos Haya Hospital, Malaga, Spain
2Departament of Clinical Allergology and Immunology, University of Navarra, Pamplona, Spain (GA2LEN Collaborative Center)
3Allergology Service, Hospital de Basurto, Bilbao, Spain
4Allergology Service, Hospital Virgen del Camino, Pamplona, Spain

J Investig Allergol Clin Immunol 2010; Vol. 20(2): 103-109



Evaluation of allergic reactions to drugs is difficult because of the poor sensitivity of in vivo tests, which makes controlled administration of the drug necessary to confirm the diagnosis. In vitro tests are important in order to avoid the risks of in vivo testing. In the present review, we describe the different methods for detecting immunoglobulin (Ig) E antibodies that are specific to drugs involved in the development of type I (immediate)
reactions. The 2 main in vitro methods are immunoassays and the basophil activation test, both of which have sufficient sensitivity and specificity for the detection of specific IgE antibodies, although with a limited number of drugs, and they have proven complementary to in vivo methods.
We show the importance of the allergological workup of the patient within less than 1 year from the occurrence of the allergic reaction in order to obtain positive results in both in vivo and in vitro tests.

Key words: Allergy. IgE. In vivo test. In vitro test. Drug. Immunoassay. Basophil activation test.