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Research Pooled Donor- BAT CU
Immune System

Pooled Donor- BAT CU

Other names: Chronic Urticaria PD-BAT

Optimal Result: 0 - 10.6 %.

What is the Pooled Donor – BAT CU test?

Pooled Donor – BAT CU is part of a specialized blood test panel used to evaluate the autoimmune activity underlying chronic spontaneous urticaria (CSU)—a condition marked by persistent hives, itching, and swelling that lasts for more than 6 weeks without an obvious allergic cause.

The “BAT” stands for Basophil Activation Test, and this specific version uses pooled donor basophils—white blood cells from healthy individuals—to assess whether your serum contains autoantibodies or factors that can trigger allergic-like immune activation.

What does this marker measure?

This test looks at how your blood (serum) interacts with donor basophils to see if it causes them to become activated. When basophils are activated, they release histamine and other chemicals that cause hives and swelling.

A positive Pooled Donor BAT CU result means your immune system is likely producing substances—often autoantibodies against IgE or its receptor (FcεRI)—that activate basophils and may be driving your chronic urticaria.

What does a positive result mean?

If your Pooled Donor – BAT CU result is elevated or positive, it suggests:

  • Your chronic hives may have an autoimmune basis (autoimmune CSU)

  • Your immune system is likely triggering your symptoms without a known allergen

  • You may respond better to certain treatments, such as:

    • Omalizumab (an anti-IgE biologic)

    • Immunosuppressive therapy in severe, refractory cases

    • Longer treatment duration may be required compared to non-autoimmune urticaria

This result provides insight into why your hives are occurring, especially when skin prick or allergy tests come back negative.

What does a negative result mean?

A negative BAT CU result indicates that no significant activation of donor basophils occurred in response to your serum. This may suggest:

  • Your chronic urticaria is not autoimmune-driven, or

  • Autoantibodies are present at levels too low to detect

  • Another mechanism, such as non-specific mast cell activation, may be responsible

Even with a negative result, treatment is still available and often includes antihistamines, leukotriene receptor antagonists, or biologics like omalizumab.

Next Steps After Testing

If your result is positive:

  • Your provider may classify your urticaria as autoimmune chronic spontaneous urticaria

  • This can help guide more effective treatment options and set realistic expectations

  • You may be monitored more closely for treatment resistance or systemic involvement

If your result is negative:

  • Other causes of chronic hives may be explored, including non-autoimmune triggers, stress, infections, or environmental factors

Bottom Line

The Pooled Donor – BAT CU test helps uncover whether autoimmune activity is triggering your chronic hives. A positive result supports a diagnosis of autoimmune urticaria, helping your doctor choose treatments that work better for your specific immune profile. If you’ve been struggling with hives for weeks or months without answers, this test can offer important insights.

What does it mean if your Pooled Donor- BAT CU result is too high?

A high result on the “Pooled Donor – BAT CU” (Basophil Activation Test for Chronic Urticaria) indicates that your serum activated donor basophils, suggesting that your chronic urticaria is likely autoimmune in nature.

What a High (Positive) Result Means:

  • Your immune system is likely producing autoantibodies—usually against:

    • IgE (the allergy antibody)

    • Or its receptor (FcεRI) on basophils and mast cells

  • These autoantibodies trigger histamine release and other inflammatory chemicals—even without allergens—leading to spontaneous hives (urticaria)

  • A high result supports the diagnosis of Autoimmune Chronic Spontaneous Urticaria (aiCSU)

What This Means for You:

  • Your chronic hives may not be allergy-related, but rather caused by your own immune system mistakenly activating inflammatory pathways

  • You may be less responsive to antihistamines alone

  • You are more likely to benefit from:

    • Omalizumab (Xolair) – a monoclonal antibody that blocks IgE

    • Other immunomodulatory treatments if symptoms are severe or persistent

    • A longer treatment course may be needed compared to non-autoimmune CSU

Important Notes:

  • A high BAT CU result does not mean you have a systemic autoimmune disease, but rather that your chronic hives are likely immune-mediated

  • It helps differentiate autoimmune urticaria from other types (like idiopathic or allergy-related)

Next Steps:

  • Discuss targeted treatment options with your allergist or immunologist

  • Your doctor may adjust your medication plan or consider biologic therapy

  • Ongoing monitoring may be recommended if symptoms are severe or unresponsive

Bottom Line:

A high result on the Pooled Donor – BAT CU test strongly suggests that your hives are caused by immune system overactivity, not allergens. This insight can guide more effective treatment and help you manage your chronic urticaria with a clearer understanding of its root cause.

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