Drug-induced lymphocyte stimulation test in the prediction of drug-induced hypersensitivity to antituberculosis drugs

• Published in: Diagnostic microbiology and infectious disease Vol. 82; no. 2; pp. 172 - 176
• Main Authors: Sun, Qin, Sha, Wei, Gui, Xu-Wei, Xiao, Yang-Jiong, Zeng, Wei-Hong, Sun, Wen-Wen, Xiao, He-Ping, Ye, Wei-Yi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2015
• Subjects: Adolescent; Adult; Adverse drug reaction; Aged; Aged, 80 and over; Antitubercular Agents - adverse effects; Cytological Techniques - methods; Drug Hypersensitivity; Drug-induced hypersensitivity; Drug-induced lymphocyte stimulation test; Female; Humans; Infectious Disease; Internal Medicine; Lymphocyte Activation - drug effects; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Sensitivity and Specificity; Toxicology - methods; Tuberculosis; Young Adult; Tuberculosis; Adverse drug reaction; Drug-induced hypersensitivity; Drug-induced lymphocyte stimulation test
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2015.03.008

Abstract Antituberculosis (TB) chemotherapeutic drugs may cause a variety of adverse drug reactions (ADRs). To assess the potential of drug-induced lymphocyte stimulation test (DLST) in screening ADRs in patients treated with anti-TB drugs, we performed DLST in 272 TB patients (176 cases with ADRs and 96 controls without ADRs) treated with anti-TB drugs isoniazid (INH), rifampicin (RFP), ethambutol (EMB), and pyrazinamide (PZA). The ADRs were diagnosed by drug provocation test based on clinical and laboratory examinations. The sensitivities of DLST in the diagnosis of INH-, RFP-, EMB-, or PZA-induced ADRs were 57.8%, 37.1%, 42.4%, and 23.1%, respectively, with the corresponding specificities being 93.4%, 94.0%, 97.5%, and 98.8%. DLST has high specificity and limited sensitivity in the diagnosis of anti-TB drug-induced ADRs. In combination with clinical observation and drug use history, DLST could have a predictive validity of ADRs, especially when a positive result is obtained.