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In vitro release of interferon-gamma from peripheral blood lymphocytes in cutaneous adverse drug reactions.

Goldberg I, Hanson M, Chodick G, Shirazi I, Brenner S - Clin. Dev. Immunol. (2012)

Bottom Line: When assessed against the questionnaire data collected at least 6 months after stopping the causative drug, sensitivity was found to be 83.61% and specificity 92.67%.Positive predictive value is 75.37% and negative predictive value is 95.47%.The test was found to perform significantly better in females and in older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 64239, Israel. ilangoldberg1@gmail.com

ABSTRACT

Background: Cutaneous drug reactions are common but diagnostically challenging due to phenotypic heterogeneity and simultaneous exposure to multiple drugs. These limitations prompted the development of diagnostic tests.

Aims: To evaluate the performance of an in vitro assay measuring interferon-gamma release from patients' lymphocytes in the presence of causative drugs for the diagnosis of drug reactions.

Methods: Mononuclear cells derived from patients were incubated with and without suspected drugs, and increment of interferon-gamma levels was measured by ELISA. We performed a telephonic survey to evaluate the effect of stopping the drugs incriminated by the assay on cutaneous manifestations.

Results: We assessed 272 patients who used 1035 medications. When assessed against the questionnaire data collected at least 6 months after stopping the causative drug, sensitivity was found to be 83.61% and specificity 92.67%. Likelihood ratio for a positive test is 11.40 and for a negative test 0.18. Positive predictive value is 75.37% and negative predictive value is 95.47%. The test was found to perform significantly better in females and in older patients.

Conclusions: Interferon-gamma release test is a useful adjunct tool in the diagnosis of cutaneous drug reactions.

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Related in: MedlinePlus

Division of study population. *It cannot be determined whether continuing the suspected drug is indeed responsible for the continuing clinical symptoms. **It cannot be determined whether the drug that was found negative in the test is indeed not responsible for the clinical symptoms.
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Related In: Results  -  Collection


getmorefigures.php?uid=PMC3375157&req=5

fig1: Division of study population. *It cannot be determined whether continuing the suspected drug is indeed responsible for the continuing clinical symptoms. **It cannot be determined whether the drug that was found negative in the test is indeed not responsible for the clinical symptoms.

Mentions: Based on these data, we divided our population into 4 groups (Figure 1):


In vitro release of interferon-gamma from peripheral blood lymphocytes in cutaneous adverse drug reactions.

Goldberg I, Hanson M, Chodick G, Shirazi I, Brenner S - Clin. Dev. Immunol. (2012)

Division of study population. *It cannot be determined whether continuing the suspected drug is indeed responsible for the continuing clinical symptoms. **It cannot be determined whether the drug that was found negative in the test is indeed not responsible for the clinical symptoms.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3375157&req=5

fig1: Division of study population. *It cannot be determined whether continuing the suspected drug is indeed responsible for the continuing clinical symptoms. **It cannot be determined whether the drug that was found negative in the test is indeed not responsible for the clinical symptoms.
Mentions: Based on these data, we divided our population into 4 groups (Figure 1):

Bottom Line: When assessed against the questionnaire data collected at least 6 months after stopping the causative drug, sensitivity was found to be 83.61% and specificity 92.67%.Positive predictive value is 75.37% and negative predictive value is 95.47%.The test was found to perform significantly better in females and in older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 64239, Israel. ilangoldberg1@gmail.com

ABSTRACT

Background: Cutaneous drug reactions are common but diagnostically challenging due to phenotypic heterogeneity and simultaneous exposure to multiple drugs. These limitations prompted the development of diagnostic tests.

Aims: To evaluate the performance of an in vitro assay measuring interferon-gamma release from patients' lymphocytes in the presence of causative drugs for the diagnosis of drug reactions.

Methods: Mononuclear cells derived from patients were incubated with and without suspected drugs, and increment of interferon-gamma levels was measured by ELISA. We performed a telephonic survey to evaluate the effect of stopping the drugs incriminated by the assay on cutaneous manifestations.

Results: We assessed 272 patients who used 1035 medications. When assessed against the questionnaire data collected at least 6 months after stopping the causative drug, sensitivity was found to be 83.61% and specificity 92.67%. Likelihood ratio for a positive test is 11.40 and for a negative test 0.18. Positive predictive value is 75.37% and negative predictive value is 95.47%. The test was found to perform significantly better in females and in older patients.

Conclusions: Interferon-gamma release test is a useful adjunct tool in the diagnosis of cutaneous drug reactions.

Show MeSH
Related in: MedlinePlus