Role of the basophil activation test in the diagnosis and management of immediate drug reaction to injectable growth hormone preparation: a case report.

Hypersensitivity reactions to synthetic hormones are rare but can represent serious complications. Allergic responses to synthetic human growth hormone (rhGH) pharmaceutical preparations are uncommon. Despite their rarity, such reactions pose a significant clinical dilemma due to the associated risks and implications for ongoing treatment. Diagnosis is further complicated by the absence of standardized and commercially available in vitro tests, while in vivo testing carries the risk of systemic reactions, even at high dilutions. We report the case of a 6-year-old patient who experienced a severe reaction following rhGH administration. The diagnosis was investigated using the basophil activation test (BAT) prior to any in vivo testing. Given the potential risks of in vivo diagnostics, as previously reported in the literature, the BAT was employed to confirm the diagnosis and to identify a safe alternative rhGH formulation, which yielded negative results both in BAT and subsequent in vivo testing.