Hypersensitivity immune reaction as a mechanism for dilevalol-associated hepatitis.
OBJECTIVE
To assess lymphocyte reactivity to dilevalol and to serum containing putative ex vivo dilevalol antigens or metabolites in a case of dilevalol-induced liver injury.


METHODS
A 58-year-old woman with a clinical diagnosis of dilevalol-induced liver injury.


METHODS
Peripheral blood mononuclear cells collected from the patient were cultured in the presence of a solution of dilevalol and also with sera collected from a volunteer before and after dilevalol intake. A similar protocol was performed with lymphocytes from a healthy subject.


RESULTS
No lymphocyte proliferation was observed either in the patient or in the healthy volunteer in the presence of dilevalol solutions. A significant proliferative response to serum collected after dilevalol intake was observed in the case of the patient compared with the proliferative response to the serum collected before the drug intake. No reactivity was found when lymphocytes from the healthy subject were tested under similar conditions.


CONCLUSIONS
The methodology used allowed the detection of lymphocyte sensitization to sera containing ex vivo-prepared dilevalol antigens, suggesting the involvement of an immunologic mechanism in dilevalol-induced liver injury.
Maria
V A
VA
Medicine 2/Clinical Immunology, Faculty of Medicine of Lisbon, Portugal.
Victorino
R M
RM
D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology / Q000276:immunology*; D004342:Drug Hypersensitivity / Q000209:etiology / Q000276:immunology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007741:Labetalol / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008213:Lymphocyte Activation / Q000187:drug effects; D008214:Lymphocytes / Q000276:immunology; D008875:Middle Aged
D007741:Labetalol