The potential of using enzyme-linked immunospot to diagnose cephalosporin-induced maculopapular exanthems.
There is no reliable test to diagnose cephalosporin-induced maculopapular exanthems (MPE). This study aimed to evaluate the role of enzyme-linked immunospot assay in the diagnosis of cephalosporin-induced MPE compared with skin testing. A total of 25 patients with a history of cephalosporin-induced MPE were skin tested and the frequencies of cephalosporin-specific interferon-γ-, interleukin-5-, and interleukin-10-releasing cells/10(6) peripheral blood mononuclear cells were measured after stimulating with the culprit drug, compared with 20 non-allergic controls. Values greater than means+2 standard deviations of the values in non-allergic controls were considered diagnostic. The study showed that the combination of interferon-γ and interleukin-5 enzyme-linked immunospot assays was more sensitive than skin testing to diagnose cephalosporin allergy (40% vs. 8%, p = 0.008) and sensitivity increased to 57.1% when the test was performed within 2 years of the drug reaction. Enzyme-linked immunospot assay is a promising tool for confirming the diagnosis of cephalosporin-induced MPE.
Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Boonthorn
B
Tanvarasethee
Supranee
S
Buranapraditkun
Jettanong
J
Klaewsongkram
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002511:Cephalosporins / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D058501:Enzyme-Linked Immunospot Assay; D005076:Exanthema / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D016753:Interleukin-10 / Q000378:metabolism; D015848:Interleukin-5 / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D008875:Middle Aged
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015848:Interleukin-5; D016753:Interleukin-10; D007371:Interferon-gamma