[A CASE OF ORAL MITE ANPHYLAXIS IN WHICH BASOPHIL ACTIVATION TEST WAS USEFUL FOR DIAGNOSIS]

We treated a 13-year-old girl who developed dyspnea after ingestion of okonomiyaki, a Japanese savory pancake prepared from takoyaki flour mix that was opened several months ago and had been stored at ambient temperature. She was found to be sensitized to mite antigen, and microscopic examination of the flour specimen revealed contamination with mites. Therefore, she was diagnosed with oral mite anaphylaxis (OMA). For a more definitive diagnosis, we performed the basophil activation test (BAT) not only in this patient but also in a healthy woman who was not sensitized to mite (control), using the mite-contaminated flour and unopened takoyaki flour mix as antigens. The objective was to rule out the possibility of non-specific basophil activation induced by takoyaki flour mix. A strong activation of the patient's basophils was observed on stimulation with mite-contaminated flour, whereas no reaction was observed on stimulation with flour from the unopened pack. In the healthy control, no reaction was observed on stimulation with either of the flour samples. We demonstrate that BAT may be a useful substitute to the oral food challenge test for the auxiliary diagnosis of OMA.