Diagnosis of propofol allergy: the innovative role of the basophil activation test in the identification of allergen: a case report

Drug allergies (DA), particularly to anesthetics, are underexplored in Morocco. Traditional diagnostic methods such as skin tests and specific IgE assays are costly, risky, and often inaccessible. The basophil activation test (BAT) is emerging as a safer and more effective alternative, especially for diagnosing propofol allergy, an under-researched area. This study examines the role of the basophils activation test in diagnosing perioperative anaphylaxis to propofol. A 32-year-old woman experienced two anaphylactic reactions during fibroscopy after propofol administration. The basophil activation test (BAT) was performed one week later using diluted propofol, measuring basophil activation via CD63 and CD203c markers by flow cytometry. Results showed 0% basophil activation in the negative control, 85.7% in the positive control, and 19.05% at 1 mg/ml of propofol, with a strong correlation (0.973) between concentration and activation. The basophil activation test (BAT) offers a reliable diagnostic method, particularly in Morocco, where traditional tests are limited, providing a cost-effective solution for diverse allergens in low-resource settings.