A Case of Anaphylaxis in Which a Basophil Activation Test was Used to Identify the Suspected Agent

Abstract

  Anaphylaxis can occur during general anesthesia and is a serious complication for patients. We report a case of anaphylaxis in which a basophil activation test was used to identify the suspected agents. A 9-year-old boy was scheduled for dental treatment under general anesthesia at our hospital. Anaphylaxis immediately occurred following the induction of general anesthesia and the initiation of dental treatment. Therefore, we discontinued the procedure. Since the patient had a severe gagging reflex and multiple dental caries, general anesthesia was compulsory to proceed with treatment. Therefore, it was necessary to identify the suspected agent that had caused the anaphylaxis before performing a second general anesthesia induction. The patient and his parents did not provide consent for skin testing, which would have allowed us to identify the suspected allergen. However, they consented to undergo blood tests. We performed a basophil activation test (BAT), which was strongly positive for latex. Subsequently, we performed a second procedure with general anesthesia under latex-free conditions and completed the treatment successfully without a recurrence of anaphylaxis.

  Skin tests are considered the most effective means of identifying agents suspected of causing anaphylaxis ; however, they are painful and involve a risk of inducing anaphylaxis during the test. Alternatively, the BAT has the advantage of not carrying such a risk. Moreover, BAT has increasingly attracted attention worldwide because of its high sensitivity and specificity for identifying suspected agents causing anaphylaxis and for having a diagnostic accuracy equivalent to that of skin testing. In the future, BAT is likely to be used more frequently in tests for anaphylaxis allergens under similar conditions.