Specific in-vitro IgE Testing to Opiates - From Richard Steele, Kathryn Patchett

Dear All

As you can see, availability for this testing (by CAP) is quite widely available

Thanks to Kathryn & Richard for adding to the chorus:

Specific In-Vitro IgE Testing to Opiates – From Daman Langguth

Thanks to Daman for his further clarification on this topic:

Specific In-Vitro IgE Testing to Opiates – From Penny Fitzharris

I believe Wellington has the "morphine" sIgE suggestive of NMBA hypersensitivity.

Specific In-Vitro IgE Testing to Opiates – From Robert Puy

HNY to all,

IgE antibodies to morphine (generally available as Phadia RAST) bind its single substituted ammonium group. They also bind neuromuscular blocking drugs at their substituted ammonium ions. The function of the test is to detect such antibodies in the investigation of anaphylaxis during general anaesthesia. Morphine itself single binding site for IgE and it cannot therefore cross-link IgE on the mast cell surface. If the clinical problem is rash or hypotension with opiates, it is likely due to a direct effect of the opiate on the mast cell and detection of IgE to morphine or other opiate would not be useful. 

 

Robert Puy

Specific IgE to Opiates - From Chris Bundell

PathWest QEII, Western Australia has the morphine cap for the Immunocap 250,  but we don't however have caps for the others.

 

Regards

Chris Bundell  PhD (UWA)

Clinical Immunology

PathWest Laboratory Medicine

QEII Medical Centre

Locked Bag 2009

Nedlands

Western Australia  6009

 

Tel:       (08) 9346 1844

Fax:      (08) 9346 3160

Specific in-vitro IgE ("RAST") testing for opiates - From Myfanwy Spellerberg

Myfanwy passes on the following enquiry:

"We have had a request from a consultant anaesthetist to provide testing for Allergy to Morphine, Codeine and Fentanyl  ( all Opiates )

In a patient with a history of bad reactions to opiates who is scheduled for THJR  

I was hoping that a RAST or similar type  test would be available.

It would appear that it is not being done in New Zealand

It would be a great help if you could check with the Immunology websites and advise if It is available elsewhere in Australasia."