[In vitro allergy testing]

[Basophil activation test as in vitro assay for cisplatin allergy]

During chemoembolization with gemcitabine, mitomycin and cisplatin of a cholangiocellular carcinoma and after receiving iodide contrast media, a 49-year-old patient developed a grade III anaphylactic reaction. We were asked to verify an adverse reaction to contrast media. Using the basophil activation test, we demonstrated a hypersensitivity reaction to cisplatin with distinct induction of CD63-expression on basophilic granulocytes.

[Diagnostic methods for confirming drug-allergy--the lymphocyte transformation test in dermatology]

Recognizing the adverse drug reactions and confirming the role of the drug causing the symptoms is a great challenge for a medical team. The aim of this article is to review the diagnostic methods for confirming drug-allergy and to evaluate the lymphocyte transformation test according to dermatological aspect. Lymphocyte transformation test relies on the observation that specific T-cells divide and expand after encountering the antigen. T-cell sensitization is measured by 3H-thymidine uptake in dividing cells. The main advantage of this test is its applicability with many different drugs in different immune reactions, as drug-specific T-cells are almost always involved in drug hypersensitivity reactions. Its disadvantage is that the test is cumbersome and technically demanding. The method is not unequivocally accepted, it is necessary to carry out a systematic evaluation of its sensitivity and specificity to make the test more widely appreciated. Despite of its deficits, the lymphocyte transformation test plays an important role in diagnosing drug-hypersensitivities.