HISTAMINE-RELEASE ASSAY AND RADIOIMMUNOASSAY FOR THE DETECTION OF IGEANTIBODIES AGAINST NEUROMUSCULAR BLOCKING-DRUGS

It is well established that muscle-relaxant drugs may be responsible f or anaphylactoid reactions during anaesthesia. In the present work we evaluated in 41 patients who had experienced anaphylactoid reactions d uring general anaesthesia, the value of differents radioimmunoassays ( RIAs) and of an histamine release assay (HRA). The RIA were performed with different solid phases as PAPPC (para amino phenyl phosphoryl cho line), morphine, TMA (trimethylamine) and TEA (triethylamine). The res ults were expressed as the percentage of I-125 anti-human IgE adsorbed onto the solid phase. The sensitivity was estimated respectively at 9 5, 82, 93 and 64 %. The results were significantly in accordance with those obtained with QAS-RIA (from GUEANT) but a weak correlation was s een with Phadebas Rast succinylcholine (r = 0,85 and 0,53 respectively ). The HRA gave with the NMBD incriminated a sensitivity of 88 %. The correlation between HRA and IDR for the drug involved was 89 % and 43 % for the other NMBDs. The PAPPC RIA was apparently the most efficient test to screen sera for the presence of IgE antibodies whatever the N MBDs involved in anaphylaxis. An advantage is that this solid phase is commercially available and therefore this RIA can be used routinely w ith a high sensitivity, allowing the comparison of the results obtaine d by different laboratories.