Basophil activation test has high reproducibility and is feasible in the clinical setting

Hannah Jaumdally, Matthew Kwok, Zainab Jama, Rochelle Hesse-Lamptey, Richard McKendry, Oliver Galvez, Yvonne Daniel, Alexandra F. Santos*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Background: The basophil activation test (BAT) has high accuracy to diagnose peanut allergy and can reduce the need for oral food challenges (OFC); however, so far it has not been incorporated in clinical practice. Methods: We assessed the reproducibility of BAT within the same laboratory and between two different laboratories and the feasibility of using BAT in the clinical setting. Results: One hundred and two children being assessed for peanut allergy were tested on BAT (72 allergic, 30 sensitized tolerant). There was little internal variation (coefficient of variation <15%) in the BAT and a very strong correlation (Rs >.95) between BAT performed across laboratories. The 2 BAT methods were strongly correlated but not interchangeable. In the cases of discrepancy, our in house BAT method was 100% accurate. BAT was feasible and well-accepted by clinicians: no patient with positive BAT was referred for OFC, leading to reduction in the number of OFC required. Twenty one percent of patients who underwent OFC reacted to peanut. A negative BAT also encouraged the performance of OFC in sensitized children who would otherwise be considered allergic, 50% of whom did not react and incorporated peanut in the diet. Conclusions: The BAT is a robust test that can reliably be transferred between laboratories; however, different BAT methods are not interchangeable. BAT was well integrated in the clinical decision-making process in a specialized center.

Original languageEnglish
Article numbere13870
JournalPediatric Allergy and Immunology
Issue number11
Publication statusPublished - Nov 2022


  • anaphylaxis
  • basophil activation test
  • CD203c
  • CD63
  • diagnosis
  • food allergy
  • oral food challenge
  • peanut allergy


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