title: Drug lymphocyte stimulation test is not useful for side effects of anti-tuberculosis drugs despite its timing.
abstract: BACKGROUND
  Some patients have adverse reactions to anti-tuberculosis drugs. We have reported that drug lymphocyte stimulation testing (DLST), which we performed at Week 1 of adverse reactions, provides little useful information (14.9% sensitivity). However, it remains unclear whether  the time of performance of the DLST contributed to these results.
  
  
  METHODS
  Patients with adverse reactions to anti-tuberculosis drugs, including rash, hepatitis and fever, underwent DLST in the first week of the adverse reaction and were then randomly assigned to Group A (among whom a second  DLST was performed 2 months after the reaction) or Group B (among whom a second DLST was performed >12 months after the reaction). We compared Group A with Group B to determine the optimal timing for the performance of DLST. The causative drug was identified by an oral drug provocation  test.
  
  
  RESULTS
  Consistent with the previous study, the sensitivity of DLST performed in the first week was low (14.3%). For DLST performed later, the sensitivity in Group A and Group B was respectively 5.0% and 6.7%.
  
  
  CONCLUSIONS
  DLST is not useful for determining the causative drug  in patients with rash, hepatitis or fever reactions to anti-tuberculosis drugs, regardless of when it is performed.
authors: Department of Respiratory Medicine, Tenryu Hospital, National Hospital Organization, Hamamatsu, Japan. miwamaro11@yahoo.co.jp
authors: S
authors: S
authors: Miwa
authors: Y
authors: Y
authors: Suzuki
authors: M
authors: M
authors: Shirai
authors: H
authors: H
authors: Ohba
authors: M
authors: M
authors: Kanai
authors: T
authors: T
authors: Eifuku
authors: T
authors: T
authors: Suda
authors: H
authors: H
authors: Hayakawa
authors: K
authors: K
authors: Chida
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects*; D049109:Cell Proliferation / Q000187:drug effects; D002478:Cells, Cultured; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D007564:Japan; D008213:Lymphocyte Activation / Q000187:drug effects*; D008214:Lymphocytes / Q000187:drug effects* / Q000276:immunology; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents