In vitro diagnostic tests for perioperative hypersensitivity, a narrative review: potential, limitations, and perspectives

Tomonori Takazawa*, Vito Sabato, Didier G. Ebo

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

58 Scopus citations

Abstract

Correct diagnostic management of perioperative hypersensitivity aims to identify the underlying mechanism(s), responsible culprit(s), and safe alternative drugs or techniques. Although drug provocation tests are considered the gold standard, diagnosis of perioperative hypersensitivity mainly relies on skin testing. Use of in vitro tests, such as quantification of specific immunoglobulin E antibodies, serum tryptase, and plasma histamine, as well as basophil activation tests is becoming widespread. These latter tests have the advantage of having no risk of recurrence of immediate hypersensitivity reactions. In this narrative review, we summarise the principles of these in vitro tests, and the possibilities and limitations when these tests are used for testing sensitivity to substances with a high risk of causing perioperative hypersensitivity. Hence, we focus on neuromuscular blocking agents, antibiotics, natural rubber latex, and opiates/opioids. The combination of multiple tests would allow diagnosis of perioperative hypersensitivity with the right balance of safety and accuracy.

Original languageEnglish
Pages (from-to)e117-e125
JournalBritish Journal of Anaesthesia
Volume123
Issue number1
DOIs
StatePublished - 2019/07

Keywords

  • allergy
  • anaesthesia
  • anaphylaxis
  • basophil activation test
  • hypersensitivity
  • perioperative
  • skin test
  • specific IgE

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint

Dive into the research topics of 'In vitro diagnostic tests for perioperative hypersensitivity, a narrative review: potential, limitations, and perspectives'. Together they form a unique fingerprint.

Cite this