KMID : 0988920180160020273
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Intestinal Research 2018 Volume.16 No. 2 p.273 ~ p.281
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Evaluation of the drug-induced lymphocyte stimulation test for diagnosing mesalazine allergy
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Saito Daisuke
Hayashida Mari Sato Taro Minowa Shintaro Ikezaki Osamu Mitsui Tatsuya Miura Miki Sakuraba Akihito Hisamatsu Tadakazu
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Abstract
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Background/Aims: Mesalazine is an effective drug for treating ulcerative colitis (UC), but causes allergic symptoms in a few cases. Therefore, the objective of this study was to evaluate the usefulness of the drug-induced lymphocyte stimulation test (DLST) for the diagnosis of mesalazine allergy.
Methods: Patients with UC treated with mesalazine with or without a history of associated adverse events (AEs) were enrolled at Kyorin University Hospital from July 2016 to April 2017.
Results: The DLST was performed in 104 patients with UC, of which 24 had a history of AEs due to mesalazine treatment. The control value of DLST was 337.4¡¾296.3 counts per minute (cpm) in the AE+ group and 408.0¡¾371.9 cpm in the AE? group. The measured value of DLST was 578.8¡¾424.7 cpm in the AE+ group and 476.5¡¾471.8 cpm in the AE? group. The stimulation index (SI) was 243.9%¡¾291.1% in the AE+ group and 119.8%¡¾53.0% in the AE? group. The SI value and DLST positivity were significantly higher in the AE+ group than in the AE? group (P=0.030 and P=0.029, respectively). The test sensitivity and specificity were 0.240 and 0.805, respectively, and the false-positive and false-negative rate was 0.195 and 0.760, respectively.
Conclusions: The DLST for mesalazine showed low sensitivity and high specificity, suggesting that it may be useful for the definitive diagnosis of allergy to mesalazine.
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KEYWORD
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Mesalamine, Drug-induced lymphocyte stimulation test, Colitis, ulcerative
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