Sulfonamide-reactive lymphocytes detected at very low frequency in the peripheral blood of patients with drug-induced eruptions.

Abstract

BACKGROUND:

The role of T lymphocytes in mediating drug eruptions is uncertain.

METHODS:

Twenty-four patients with eruptions induced by sulfonamide-related drugs were studied to detect lymphocyte reactivity to drugs. Both the lymphocyte transformation test and limiting dilution analysis were used as assays for drug-reactive lymphocytes. Peripheral blood lymphocytes were expanded in interleukin-2 and tested for reactivity to sulfamethoxazole and furosemide.

RESULTS:

The lymphocyte transformation test results to sulfamethoxazole, sulfisoxazole, and furosemide were found to be generally unreliable with a high rate of false-negative and false-positive results. However, as determined by limiting dilution analysis, sulfamethoxazole-reactive lymphocytes were detected in the peripheral blood of one patient at a frequency of 1/172,000. This is within the lower range of frequencies of urushiol-reactive T cells in the peripheral blood of patients with allergic contact dermatitis to urushiol (poison ivy). Two sulfonamide-reactive lymphocyte lines were cultured from two patients. Both lines proliferated in response to sulfamethoxazole but not in response to furosemide, suggesting that furosemide does not cross-react with the sulfonamides.

CONCLUSIONS:

Lymphocytes reactive to sulfamethoxazole were detected at low frequencies in the peripheral blood of three patients with drug eruptions secondary to administration of sulfamethoxazole.

• Authors: R S Kalish, A LaPorte, J A Wood, K L Johnson
• Journal: The Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 94 Issue 3 Pt 1 Pg. 465-72 (Sep 1994) ISSN: 0091-6749 [Print] United States
• PMID: 8083451 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Sulfisoxazole
• Furosemide
• Trimethoprim, Sulfamethoxazole Drug Combination

Topics

• Adult
• Aged
• Cells, Cultured
• Drug Eruptions (blood, etiology)
• Female
• Furosemide (adverse effects)
• Humans
• Lymphocyte Activation (drug effects)
• Male
• Middle Aged
• Sulfisoxazole (adverse effects)
• T-Lymphocytes (drug effects, immunology)
• Trimethoprim, Sulfamethoxazole Drug Combination (adverse effects)