Urticaria-Inducing Activity
Ordering Recommendation

Determine histamine release in suspected chronic urticaria if urticaria may be due to autoimmune antibodies to the basophil IgE receptor or to IgE.

Semi-Quantitative Ex Vivo Challenge/Cell Culture/Quantitative Enzyme-Linked Immunosorbent Assay
Mon, Fri
2-6 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Patients taking calcineurin inhibitors should stop their medication for 72 hours prior to draw. Patients on prednisone should be off medication for 2 weeks prior to draw. 
Plain red. 
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube and freeze immediately. (Min: 0.5 mL) 
Storage/Transport Temperature
CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. 
Unacceptable Conditions
Specimens other than serum. Contaminated, grossly hemolyzed, or lipemic specimens. 
After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozen: 1 year (avoid repeated freeze/thaw cycles) 
Reference Interval
Effective November 14, 2011

10 Units or less
Interpretive Data
A value of greater than 10 Units suggests the presence of basophil stimulating antibodies (or other serum factors).

Statement B: Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

1) Chronic urticaria (CU) is a common and complex dermatological condition that is suspected when patients experience persistent hives for over 6 weeks. No published evidence of an exogenous allergen as the cause of this disorder exists. About 45 percent of cases have autoantibodies directed against either basophil or mast cell-associated IgE or the high affinity IgE-Fc receptor (Fc epsilon R1 alpha) (Clin Exp Allergy  2009; 39: 777-87). 

2) The presence of histamine releasing factors (including but not limited to IgE and Fc epsilon R1 alpha-specific autoantibodies) in the patient serum can be indirectly determined by evaluating basophil/mast cell activation status using histamine release assays, autologous serum-skin test, and flow cytometric measurement of the basophil and mast cell-specific marker CD203c.  Serum from CU patients can activate donor basophils, which induces histamine release and CD203c upregulation (J Allergy Clin Immunol 2006; 117: 1430-4).
Hotline History
Component Test Code*Component Chart NameLOINC
2005414Urticaria-Inducing Activity63369-3
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please view this test within the Laboratory Test Directory found at www.aruplab.com
  • CD203c upregulation