BlueCross BlueShield of Tennessee Medical Policy Manual

Allergy Testing - Leukocyte Histamine Release Test (LHRT)

DESCRIPTION

The leukocyte histamine release test (LHRT) measures the amount of histamine released in-vitro. An allergen extract in varying concentrations is added to the peripheral blood leukocytes of the individual being tested and the in vitro release of histamine from basophils in response to exposure to the allergen is measured. Histamine is normally released as a consequence of the interaction of allergen with cell-bound IgE antibodies. If an individual is hypersensitive to a specific antigen, the leukocytes will release the histamine in-vitro. Only a limited number of allergens can be tested from a single sample of blood. Quality control studies have shown variability in the measurement of histamine results.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION 

The leukocyte histamine release test is primarily used in the research setting.  Clinical data supporting its role in the clinical setting is lacking.

SOURCES 

Annals of Allergy, Asthma, & Immunology. (2008, March). Allergy diagnostic testing: an updated practice parameter. Retrieved October 17, 2016 from https://www.aaaai.org.

Auslander, D., Eggerschwiler, B., Kemmer, C., Geering, B., Auslander, S., & Fussenegger, M. (2014). A designer cell-based histamine-specific human allergy profiler. Nature Communications, 2014. (Level 4 evidence)

First Coast Service Options, Inc. (2017, May). Local Coverage Determination (LCD): Allergy testing (L33261). Retrieved August 25, 2017 from https://www.cms.gov.

Michalak, A., Lewandowska-Polak, A., Moskwa, S., Kowalski, M., & Grzegorczyk, J. (2015). IgE-mediated 15-hydroxyeicosatetraenoic acid (15-HETE) generation by peripheral blood leukocytes: its association with basophil activation. Advances in Dermatology and Allergology, 32 (4), 262-267. (Level 4 evidence)

ORIGINAL EFFECTIVE DATE:  10/12/1998   

MOST RECENT REVIEW DATE:  10/26/2017

ID_BT

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