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Allergy Testing

Allergy Testing

The Basophil Activation Test (BAT) can be used for the in vitro detection of immediate type allergic reactions and hypersensitivities to suspected allergens.


The physical symptoms of allergy can be similar to that of a sensitivity or intolerance. Roughly 20% of the population experience symptoms that make them believe they have a food allergy, but it’s estimated that only 1-10% of adults and children actually have a food allergy. The incidence of food allergies are becoming increasingly more prevalent; it’s estimated that, in the UK, 1 in 40 infants are developing a peanut allergy, and 1 in 20 infants are developing an egg allergy. With almost a third of allergy sufferers having to change their lifestyle, it’s vital to determine who is truly allergic from those who are not; BAT can be a helpful tool to do this.

About 10% of the general population claim to have a penicillin allergy, however fewer than 10% of people who think they are allergic to penicillin are truly allergic. Those with a label of penicillin allergy are more likely to be treated with broad-spectrum antibiotics, and use of broad-spectrum antibiotics is associated with an increased rate of clinical complications, such as antibiotic resistance. An unsubstantiated label of penicillin allergy may lead to the inappropriate use of broad spectrum, non-penicillin antibiotics leading to antibiotic resistance and in some cases sub-optimal therapy.

The general pathway for suspected allergy diagnosis recommends the following:

  • Firstly, a detailed clinical history of the patient will be taken
  • Based on the results of the clinical history, a healthcare professional will offer a skin prick test (SPT) and/or a blood test for specific IgE (sIgE). The results of these tests will then be interpreted along with the results of the clinical history
  • If the results from the SPT and sIgE tests are unable to confirm or exclude allergy conclusively, patients may be referred to specialist or secondary care settings for further investigation (e.g. challenge test)

Challenge tests can be unpleasant and stressful for patients and their families, as well as posing a danger to the patient. BAT can be used as a safer alternative to a challenge test if SPT and/or sIgE testing cannot offer a conclusive result- if the patient has a positive BAT result, allergy can be confirmed with a high degree of certainty; if the patient’s BAT result is negative, patients may be offered a challenge test to definitively confirm or exclude allergy.

Offering BAT before a challenge test will significantly reduce the number of patients having to undertake these tests; a peanut study undertaken by Santos et al. in 2014 has shown a 67% reduction in the need for oral food challenges. The true value of BAT lies in its high specificity, reaching 100% in some studies. This means that a positive BAT result confirms allergy with a high degree of certainty, resulting in fewer of the more dangerous positive challenge tests being performed.

Allergy Pathway

  • Allergen Product List

    • PDF size: 1.67MB
    • Updated on: 04/07/2018

    Reference list of available BÜHLMANN Allergens

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  • Basophil Activation Testing - A Safer Alternative for your Patients

    • PDF size: 11.35KB
    • Updated on: 03/09/2018

    Leading Edge Article

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  • Basophil Activation Testing Brochure

    • PDF size: 12.96KB
    • Updated on: 04/07/2018

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    • PDF size: 13.22KB
    • Updated on: 04/07/2018

    Procedure and Characteristics

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  • Drug Allergen Booklet

    • PDF size: 1.78MB
    • Updated on: 04/07/2018

    Details and References relating to the CAST Drug Allergens

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  • Flow CAST® Applications

    • PDF size: 9.60KB
    • Updated on: 04/07/2018

    Cellular Allergy Diagnosis

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  • Flow CAST® Procedure and Characteristics

    • PDF size: 13.30KB
    • Updated on: 04/07/2018

    Product Flyer

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  • Inhalant, Venom, Food and Environmental Allergens Booklet

    • PDF size: 1.34MB
    • Updated on: 04/07/2018

    Details and References relating to the CAST Inhalant, Venom, Food and Environmental Allergens

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  • Diagnosing Drug Allergy: A Rational Approach

    • PDF size: 10.26KB
    • Updated on: 05/07/2018

    Discussion by Dr Cathy van Rooyen, Allergy, Immunology & Virology Pathologist at AMPATH Pathology

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  • CAST Southampton NHST user report

    • PDF size: 11.09KB
    • Updated on: 09/07/2018

    The Department of Immunology describes their experience using the Basophil Activation Test in a clinical setting.

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Road map for the clinical application of the basophil activation test in food allergy
Santos, A.F. and Shreffler, W.G. Clin. & Exp. Allergy Volume 47, Issue 9, September 2017, Pages 1115–1124

Basophil activation test discriminates between allergy and tolerance in peanut-sensitized children
Santos at al. Journal of Allergy and Clinical Immunology;Volume 134, Issue 3, September 2014, Pages 645–652

Diagnosis of Immediate-Type ß-Lactam Allergy In Vitro by Flow-Cytometric Basophil Activation Test and Sulfi doleukotriene Production: A Multicenter Study
De Weck at al. J Investig Allergol Clin Immunol;Volume 19, Issue 2, 2009, Pages 91-109

Grid List
  • Allergen Response Assays

    Allergen Response Assays

    Using the BÜHLMANN CAST® range of Allergy assays can significantly decrease the amount of provocation tests that need to be performed.
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  • Allergens


    The complete package for allergy diagnosis also includes a library of over 150 standardised allergens that are quality controlled, validated and standardised.
    View more
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