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BRIEF RESEARCH REPORT article
Front. Allergy
Sec. Drug, Venom & Anaphylaxis
Volume 6 - 2025 | doi: 10.3389/falgy.2025.1532775
Basophil activation test and lymphocyte transformation test in cefuroximeinduced anaphylactic reactions
Provisionally accepted
Andreas Glässner 1
Diana Dubrall 1,2*
Gerda Wurpts 3 Philipp Deck 1
Günther Weindl 4
Caspar Anton Heubach 1
Amir S Yazdi 3
Bernhardt Sachs 1- 1 Federal Institute for Drugs and Medical Devices, Bonn, Germany
- 2 Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- 3 Department of Dermatology and Allergology, University Hospital RWTH Aachen, Aachen, Germany
- 4 Pharmaceutical Institute, University of Bonn, Bonn, North Rhine-Westphalia, Germany
Cefuroxime allergy may present as delayed-type reaction or as IgE-mediated immediate-type anaphylactic reaction. The basophil activation test (BAT) is a diagnostic tool in cefuroxime-induced immediate-type reactions, whereas the lymphocyte transformation test (LTT) is typically applied in delayed-type drug allergy. The objective of the experimental part of this study was to compare the results of the BAT and LTT in 15 patients with cefuroxime-induced anaphylactic reactions considered as confirmed. The aim of the pharmacoepidemiological part was to analyse spontaneous reports of cefuroxime-associated anaphylactic reactions in the European adverse drug reaction database (EudraVigilance).In EudraVigilance, 668 reports of cefuroxime-associated anaphylactic reactions for the European Economic Area (EEA) between 2010 and 2023 and thereof, 182/668 (27.2%) from Germany were analysed. The BAT and the LTT were performed according to standard protocols. Except for one patient, all BAT were performed prior to the skin tests, whereas all LTT were performed thereafter.Almost all reports were classified as serious (EEA: 99.3%, Germany: 98.9%). In 60.8% (EEA) and 66.9% (Germany) of reports with respective information the reaction occurred after intravenous administration. In 12/15 patients a BAT was performed (3/12 positive; sensitivity 25%) and in 15/15 a LTT (7/15 positive; sensitivity 46.7%). Our analysis highlights the importance of cefuroxime iassociated anaphylactic reactions, as almost all of the spontaneous reports were classified as serious. Neither a negative BAT nor LTT can rule out a sensitisation in cefuroxime-induced anaphylactic reactions.
Keywords: Cefuroxime, Anaphylactic reaction, Lymphocyte transformation test, basophil activation test Abbreviations ELISA: Enzyme-linked immunosorbent assay, IFN: Interferon, IL: interleukin, LTT: Lymphocyte transformation test, BAT: basophil activation test
Received: 22 Nov 2024; Accepted: 03 Mar 2025.
Copyright: © 2025 Glässner, Dubrall, Wurpts, Deck, Weindl, Heubach, Yazdi and Sachs. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Diana Dubrall, Federal Institute for Drugs and Medical Devices, Bonn, Germany
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