title: Detection of nickel and palladium contact hypersensitivity by a flow cytometric lymphocyte proliferation test.
abstract: We established a flow cytometric lymphocyte proliferation test (LPT) for the detection of nickel (Ni) and palladium (Pd) sensitization. Eighty-one consecutive patients with an indication for patch test (PT) were tested by LPT with Ni (NiSO4 ) and Pd (Na2 PdCl4 and PdCl2 ) salts. The imprecision of the LPT was low (coefficient of variation 7.2%). Using PT as a diagnostic reference, the sensitivity and specificity of LPT were 74.4% and 80% for NiSO4 , 74.4% and 78.3% for Na2 PdCl4 , and 57.2% and 85.4% for PdCl2 , respectively. For both Ni and Pd, the likelihood ratio for a positive PT markedly increased with increasing LPT value. With medical history as a reference, the sensitivity and specificity were 40.6% and 82.1% for LPT and 59.4% and 89.7% for PT, respectively. Combination of LPT and PT resulted in a higher specificity of 95%, albeit lower sensitivity of 34.4%. In conclusion, flow cytometric LPT represents a reliable and useful method for the detection of Ni and Pd sensitization. LPT values correlate with PT results and, when used in combination with PT, increase test specificity.
authors.affiliation: Research Group of Dermatology, Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland.
authors.forename: I
authors.initials: I
authors.lastname: Spoerri
authors.forename: K
authors.initials: K
authors.lastname: Scherer
authors.forename: S
authors.initials: S
authors.lastname: Michel
authors.forename: S
authors.initials: S
authors.lastname: Link
authors.forename: A J
authors.initials: AJ
authors.lastname: Bircher
authors.forename: I A F M
authors.initials: IA
authors.lastname: Heijnen
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects*; D010165:Palladium / Q000009:adverse effects*; D010328:Patch Tests / Q000379:methods
chemical_list: D000485:Allergens; D010165:Palladium; D009532:Nickel
keywords: allergic contact dermatitis; flow cytometry; lymphocyte proliferation test; lymphocyte transformation test; metal allergy