Abstract

FARINHA, Sofia et al. Lymphocyte transformation test in drug hypersensitivity. Rev Port Imunoalergologia [online]. 2017, vol.25, n.3, pp.173-179. ISSN 0871-9721.

Background: The lymphocyte transformation test (LTT) has been used in the study of drug allergy for the last 3 decades. It bases on the detection of a proliferative T cell response in the presence of the drug to be tested and some groups present good results in identifying a culprit drug, sensitivity and specificity differing with the drug, the reaction and other factors. Validation of LTT depends, however, on larger and better controlled studies. Aims: To evaluate the LTT performance in identifying culprit drugs in allergic reactions and analyse positivity criteria regarding different pharmacological groups and observed reactions. Methods: We analysed the results of 95 LTT tests, performed in 73 patients submitted to a drug allergy evaluation who were diagnosed with a high level of certainty by clinic and skin tests. Drug classes, type of allergic reactions and time between those and test execution were taken into account. Results: Results by drug classes showed sensitivity/specificity of 76,1% / 57,1% for beta-lactams, 83,3% / 55,5% for non steroidal anti-inflammatory drugs, 88,9% / 100% for anticonvulsivants and 46,1% / 66,7% for non beta-lactam antibiotics. Conclusions: LTT sensitivity may be considered good, except for non beta-lactam antibiotics. As expected, specificity was low for non steroidal anti-inflammatory drugs, but was lower than generally described for beta-lactams. Nevertheless, LTT showed a discriminative power of 70,6% in this study and allowed to confirm a drug allergy diagnosis in 36 cases, 58,1% of allergy sample cases, where skin tests were negative or impossible to perform. So, its use in drug allergy is completely justified, although a careful clinical history and skin tests whenever possible must not be forgotten

Keywords : Hypersensitivity drug reaction; lymphocyte transformation test; T cells.

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