[Basophil degranulation test in the diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity].

UNLABELLED: Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity affects from 5 to 30% of adult asthmatics. The diagnosis is established on the basis of anamnesis and confirmed by provocation tests, but the last one carry the risk of serious side effects. There is lack of in vitro test to diagnose NSAID hypersensitivity. The aim of our study was to establish the usefulness of basophil degranulation test in the diagnosis of NSAID hypersensitivity.

MATERIAL AND METHOD: The study population consisted of 10 patients with aspirin asthma, 6 asthmatics with tolerance of NSAID and 6 healthy subjects. NSAID hypersensitivity was confirmed by aspirin challenge. The level of specific IgE for aspirin was determined in all subjects by ELISA method. Basophil degranulation test (BDT) was performed The BDT was assessed as positive when the basophils degranulation exceeded 30% as compared to control.

RESULTS: In all NSAID hypersensitive subjects, sensitivity was confirmed by aspirin challenge. The specific IgE test was negative for all studied subjects. BDT was positive in 9 from 10 NSAID hypersensitive patients and negative in all NSAID tolerant subjects. The positive degranulation was observed in range 10 to 750 microg of aspirin/ml. One false negative result was observed in patient receiving high dose of oral glucocorticosteroids which stabilized basophils and prevent from degranulation.

CONCLUSION: BDT, when performed in increasing aspirin concentration from 50 to 500 microg/ml, seems to be a valuable and safe diagnostic method of NSAID hypersensitivity. The study revealed that sIgE for aspirin are not useful diagnostic method. The study confirmed the involvement of basophils in the NSAID hypersensitivity reaction beyond IgE system.