title: Rapid immunochromatographic test for serum granulysin is useful for the prediction of Stevens-Johnson syndrome and toxic epidermal necrolysis.
abstract: BACKGROUND
  Life-threatening adverse drug reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) sometimes start with clinical features of ordinary drug-induced skin reactions (ODSRs) and it may be difficult to make a correct diagnosis before severe mucocutaneous erosions occur. We have reported that serum granulysin levels are elevated (cut off: 10 ng/mL) in patients with SJS/TEN before generalized blisters form.
  
  
  OBJECTIVE
  We sought to develop a rapid detection system for elevated serum granulysin to predict the progression from ODSRs.
  
  
  METHODS
  Serum samples from 5 patients with SJS/TEN at 2 to 4 days before mucocutaneous erosions formed were analyzed. Sera from 24 patients with ODSRs and 31 healthy volunteers were also investigated as control subjects. We developed a rapid immunochromatographic assay for the detection of high levels of serum granulysin using two different antigranulysin monoclonal antibodies.
  
  
  RESULTS
  The immunochromatographic test showed positive results for 4 of 5 patients with SJS/TEN but only one patient of 24 with ODSRs. The results correlated closely with those of enzyme-linked immunosorbent assays.
  
  
  CONCLUSIONS
  The validation of the long-time stability in this test strip has not been investigated.
  
  
  CONCLUSIONS
  This novel test enables the prediction of SJS/TEN occurrence in patients even when only features of ODSRs are noted clinically.
authors.affiliation: Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fujita
authors.forename: Naoya
authors.initials: N
authors.lastname: Yoshioka
authors.forename: Riichiro
authors.initials: R
authors.lastname: Abe
authors.forename: Junko
authors.initials: J
authors.lastname: Murata
authors.forename: Daichi
authors.initials: D
authors.lastname: Hoshina
authors.forename: Hirokatsu
authors.initials: H
authors.lastname: Mae
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimizu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000945:Antigens, Differentiation, T-Lymphocyte / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002845:Chromatography / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000295:instrumentation / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012494:Sampling Studies; D013262:Stevens-Johnson Syndrome / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology
chemical_list: D000945:Antigens, Differentiation, T-Lymphocyte; D015415:Biomarkers; C075005:GNLY protein, human