{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:34:17Z","timestamp":1790778857289,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,8,1]],"date-time":"2014-08-01T00:00:00Z","timestamp":1406851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Allergy to atracurium is a rare condition with serious consequences of diagnostic error. However, correct diagnosis is not always straightforward. The aim of this study is to assess the utility of the basophil activation test (<jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content>) in atracurium sensitization and to investigate its role in identifying cross\u2010reactivity between muscle relaxants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For validation, eight patients with perioperative anaphylaxis to atracurium and seven individuals experiencing perioperative anaphylaxis but not exposed to neuromuscular blocking agents (<jats:styled-content style=\"fixed-case\">NMBA<\/jats:styled-content>) were included. Furthermore, five other patient groups were included in the study, and all individuals exposed to different <jats:styled-content style=\"fixed-case\">NMBA<\/jats:styled-content>, either sensitized or not to the drug. Basophil activation with atracurium was analysed flow cytometrically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> analyses between eight atracurium\u2010sensitized patients and seven nonexposed controls allowed identification of 5% as the decision threshold for <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content> positivity. For this cutoff, the <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content> attained a sensitivity of 63%, specificity of 100%, positive predictive value of 100% and negative predictive value of 70%. Of the atracurium\u2010exposed individuals with a negative atracurium skin test (ST), two individuals had a clear positive <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content> atracurium was positive in one cisatracurium\u2010sensitized patient and negative in all cisatracurium\u2010exposed patients with a negative ST to cisatracurium. All rocuronium\u2010 and suxamethonium\u2010sensitized patients displayed a negative <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content> with atracurium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content> proves to be a useful diagnostic for atracurium\u2010induced anaphylaxis and may be complementary to STs. The technique enables quick and simultaneous testing of potentially crossreactive <jats:styled-content style=\"fixed-case\">NMBA<\/jats:styled-content> and the identification of safe alternatives for future surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.12468","type":"journal-article","created":{"date-parts":[[2014,6,24]],"date-time":"2014-06-24T21:26:58Z","timestamp":1403645218000},"page":"1324-1332","source":"Crossref","is-referenced-by-count":52,"title":["Flowcytometric diagnosis of atracurium\u2010induced anaphylaxis"],"prefix":"10.1111","volume":"69","author":[{"given":"A. P.","family":"Uyttebroek","sequence":"first","affiliation":[{"name":"Department of Immunology, Allergology, Rheumatology Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"},{"name":"Department of Immunology, Allergology, Rheumatology Antwerp University Hospital Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Sabato","sequence":"additional","affiliation":[{"name":"Department of Immunology, Allergology, Rheumatology Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"},{"name":"Department of Immunology, Allergology, Rheumatology Antwerp University Hospital Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Leysen","sequence":"additional","affiliation":[{"name":"Department of Immunology, Allergology, Rheumatology Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"},{"name":"Department of Immunology, Allergology, Rheumatology Antwerp University Hospital Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. H.","family":"Bridts","sequence":"additional","affiliation":[{"name":"Department of Immunology, Allergology, Rheumatology Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"},{"name":"Department of Immunology, Allergology, Rheumatology Antwerp University Hospital Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. S.","family":"De Clerck","sequence":"additional","affiliation":[{"name":"Department of Immunology, Allergology, Rheumatology Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"},{"name":"Department of Immunology, Allergology, Rheumatology Antwerp University Hospital Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. G.","family":"Ebo","sequence":"additional","affiliation":[{"name":"Department of Immunology, Allergology, Rheumatology Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"},{"name":"Department of Immunology, Allergology, Rheumatology Antwerp University Hospital Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annfar.2005.02.008"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","unstructured":"MirajA FoaudA SethB.Cardiac arrest following an anaphylactic reaction to atracurium.2010. Available from:http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22791846.","DOI":"10.1136\/bcr.01.2010.2658"},{"key":"e_1_2_9_4_1","first-page":"442","article-title":"Reducing the Risk of Anaphylaxis During Anesthesia: 2011 Updated Guidelines for Clinical Practice","volume":"21","author":"Mertes PM","year":"2011","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_9_5_1","first-page":"868","article-title":"Hypersensitivity reactions during anesthesia. Results from the ninth French survey (2005\u20102007)","volume":"78","author":"Dong S","year":"2012","journal-title":"Minerva Anestesiol"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0002800207"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31820164d2"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20419"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1586\/eci.11.14"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02569.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01094.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(99)70386-6"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1006\/clim.2001.5156"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2004.04086.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.00978.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.allerg.2008.06.008"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02598.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01039.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.anes.0000270735.40872.f2"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-5877(00)00115-X"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12344"}],"container-title":["Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fall.12468","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.12468","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T01:00:11Z","timestamp":1696467611000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/all.12468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1111\/all.12468"],"URL":"https:\/\/doi.org\/10.1111\/all.12468","archive":["Portico"],"relation":{},"ISSN":["0105-4538","1398-9995"],"issn-type":[{"value":"0105-4538","type":"print"},{"value":"1398-9995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8]]}}}