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Updated: Sep 14, 2025
Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity
Published on: September 16, 2011
Drug hypersensitivity to vancomycin confirmed by basophil activation test: case report
Zakaria Zidane1, Chaimaa Chahine1, Sanaa Souat2
1Laboratory of Biology and Health, Research Center of Biotechnologies and Health, University Hassan II of Casablanca, Faculty of Sciences Ben Msik, Avenue Cdt Driss El Harti, B.P 7955, Sidi Othmane-Casablanca, Morocco.
Insights
This case study shows a child with immune deficiency experienced vancomycin hypersensitivity. The Basophil Activation Test (BAT) confirmed this allergy, highlighting its value for diagnosing drug hypersensitivity.
Area of Science:
- Immunology
- Allergy and Clinical Immunology
- Pharmacology
Background:
- Drug hypersensitivity reactions (DHRs) to vancomycin present diagnostic challenges, especially in pediatric patients with primary immunodeficiency.
- Immediate hypersensitivity reactions, including urticaria and angioedema, necessitate reliable diagnostic tools for effective management.
Observation:
- A 7-year-old girl with primary immunodeficiency exhibited immediate hypersensitivity to vancomycin, successfully managed with corticosteroids and antihistamines.
- Two years post-reaction, the Basophil Activation Test (BAT) demonstrated significant vancomycin-induced basophil activation (CD63 and CD203c expression).
Findings:
- The Basophil Activation Test (BAT) confirmed vancomycin hypersensitivity in the pediatric patient.
- The test showed robust basophil activation across all vancomycin concentrations, exceeding control levels.
Implications:
- The Basophil Activation Test (BAT) is a valuable in vitro diagnostic tool for confirming vancomycin hypersensitivity, particularly when skin testing or IgE assays are not feasible.
- This case supports the broader clinical adoption of BAT in allergy practice, especially in resource-limited settings, for managing drug hypersensitivity in high-risk populations.
Abstract:
Drug hypersensitivity reactions to essential antibiotics like vancomycin pose significant diagnostic and therapeutic challenges, particularly in vulnerable populations such as pediatric patients with immune deficiencies. We present the case of a 7-year-old girl with primary immunodeficiency who experienced immediate hypersensitivity reactions to vancomycin, including urticaria and angioedema, managed with corticoids and antihistamines. The Basophil Activation Test (BAT) conducted two years after the last allergic episode revealed significant basophil activation across all tested vancomycin dilutions, with CD63 and CD203c expression exceeding negative and positive controls. These findings confirm vancomycin hypersensitivity and underscore the BAT's utility as a reliable in vitro diagnostic tool, especially in settings where skin testing or specific IgE assays are unavailable. This case highlights the BAT's potential for broader adoption in clinical allergy practice, particularly in resource-limited environments. It emphasizes the importance of reliable diagnostic methods for managing drug hypersensitivity in high-risk patients.
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