BlueCross BlueShield of Tennessee Medical Policy Manual

Allergy Testing - Leukocyte Histamine Release Test (LHRT)


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.




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


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

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) Centers for Medicare & Medicaid Services. Palmetto GBA. (2019, May). Noncovered services other than CPT category III noncovered services (LCD ID L36954). Retrieved July 1, 2019 from

Larsen, L.F., Juel-Berg, N., Hansen, K.S., Clare Mills, E.N., van Ree, R., Poulsen, L.K., & Jensen, B.M. (2018). A comparative study on basophil activation test, histamine release assay, and passive sensitization histamine release assay in the diagnosis of peanut allergy. Allergy, 73 (1), 137-144. Abstract retrieved August 7, 2018 from PubMed database.

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)




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