title: Increased in vitro release of interferon-gamma from ampicillin-stimulated peripheral blood mononuclear cells in Stevens-Johnson syndrome.
abstract: Stevens-Johnson syndrome (SJS) was diagnosed in a 39-year-old woman, treated with ampicillin (4000-8000 mg daily), phenytoin (250 mg daily), and furosemide (20-40 mg daily) for 25, 21, and 20 d, respectively, before the appearance of the eruption. The lymphocyte stimulation test with the MTT [3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay on ampicillin, phenytoin, and furosemide showed a low value of stimulation index, which indicated negative reactivity. An in vitro IFN-gamma release test was conducted on the patient with SJS and on two healthy controls. IFN-gamma release increased by 52% following the in vitro challenge of the patient's peripheral blood mononuclear cells (PBMCs) with 15 microg/ml of ampicillin, but not with phenytoin or furosemide. Neither of the controls experienced increased IFN-gamma release. In the present case, increased in vitro IFN-gamma release was observed on ampicillin-stimulated PBMCs, which may indicate the role of ampicillin as the drug responsible for the induction of SJS, and may imply the role of IFN-gamma in the pathogenesis of SJS.
authors.affiliation: Department of Pharmacy, Ogaki Municipal Hospital, Gifu, Japan. pharm@omh.gifu.ac.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Yoshimura
authors.forename: Emi
authors.initials: E
authors.lastname: Hamaguchi
authors.forename: Eiseki
authors.initials: E
authors.lastname: Usami
authors.forename: Keiji
authors.initials: K
authors.lastname: Nakashima
authors.forename: Mayumi
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Norio
authors.initials: N
authors.lastname: Suzuki
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Toshiya
authors.initials: T
authors.lastname: Nakao
authors.forename: Futoshi
authors.initials: F
authors.lastname: Yamazaki
mesh_terms: D000328:Adult; D000667:Ampicillin / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D007963:Leukocytes, Mononuclear / Q000187:drug effects* / Q000378:metabolism*; D013262:Stevens-Johnson Syndrome / Q000097:blood* / Q000139:chemically induced
chemical_list: D000667:Ampicillin; D007371:Interferon-gamma