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.

Mnemonic
UIA
Methodology

Semi-Quantitative Ex Vivo Challenge/Cell Culture/Quantitative Enzyme-Linked Immunosorbent Assay

Performed

Mon, Fri

Reported

11-14 days

New York DOH Approval Status
This test is New York DOH approved.
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.

Collect

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.

Remarks
Stability

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).

Compliance Category

Laboratory Developed Test (LDT)

Note

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
N/A
CPT Codes

86352

Components
Component Test Code* Component Chart Name LOINC
2005414 Urticaria-Inducing Activity 63369-3
* 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 click the sidebar link to access the Interface Map.
Aliases
  • CD203c upregulation
Urticaria-Inducing Activity