The importance of basophil activation test in clinical diagnosis and follow-up in children with milk allergy

Aim: The aim of this study was to evaluate the role of basophil activation test (BAT) in the diagnosis, treatment and follow-up of children with milk allergy and to compare it with other diagnostic tests used routinely. Materials and Methods: 26 Patients aged 0-18 years with milk allergy who were admitted to Gaziantep University Pediatric Allergy Immunology outpatient clinic between 01.02.2023-31.03.2023 were included in the study. Anamnesis and physical examination findings were noted from the children of the families who agreed to participate in the study. All patients underwent skin prick test and hemogram, total IgE level and milk specific IgE levels were measured. Basophil activation test was performed in patients with milk allergy or positive milk specific IgE levels in the skin prick test. Results: It was determined that 57,7% of the patients were ≤ 2 years old, 61.5% were male, and 53.8% had a family history. Skin-mucosa symptoms were present in 69.2% , respiratory symptoms in 23.0% and abdominopelvic symptoms in 15.4% of the patients. Casein Specific IgE and Milk Specific IgE values were found to be statistically significantly higher in patients who developed reaction/anaphylaxis in the Cake provocation test and Cheese and pastry provocation test compared to patients who did not develop reaction (p=0.004, p=0.019, p=0.002 and p=0.019, respectively). BAT Casein and BAT milk values were found to be higher in patients who developed multiple allergies and in patients who developed reaction/anaphylaxis in cake, cheese pastry, yogurt soup, yogurt and milk provocation tests. There were positive, moderate and statistically significant correlations between BAT Casein and BAT Milk values and Casein SP IgE, Milk SP IgE and anaphylaxis score values, and positive, strong and statistically significant correlations between DPT milk mean, DPT casein mean, DPT casein histamine and DPT milk histamine values. Conclusion: BATs can complement conventional tests and contribute to better discrimination of allergic patients.