Паёми Сино (Jun 2018)
DETECTION OF DRUG ALLERGY ON ANTITUBERCULOSIS DRUGS USING LEUKOCYTES LYSIS SENSIBILIZATION REACTION AND TOTAL IMMUNOGLOBULIN E
Abstract
Objective: Detecting the presence of drug allergy (DA) for anti-TB preparations on the basis of the studying of the immune mechanisms of DA in tuberculosis. Methods: Performed identification of the first and fourth types of DA for anti-tuberculosis drugs in 163 tuberculosis (TB) patients. Tuberculosis of the lungs (TBL) was diagnosed in 109 (66.9%) patients, of which 43 (39.4%) had multiple drug resistance (MDR) of Mycobacterium tuberculosis and 66 (60.6%) – drug sensitivity (DS). Extrapulmonary tuberculosis (EPLT) was detected in 54 (33.1%) of the 163 patients examined. We used a leukocyte lysis sensibilization reaction (LLSR) and quantified the concentration of total immunoglobulin of E class (IgE) by immunoferment analysis (IFA). The material of the study served as the samples of peripheral blood. Results: Positive LLSR+ for one or more drugs was detected in 103 (63.2%) of the 163 patients with TB, weakly positive LLSR± in one or more drugs – in 43 (26.4%) and negative LLSR- for all studied drugs – in 17 (10.4%) patients with TB. The highest relative number of LLSR+ showed an examination in DA of MDR TBL patients (30 of 43 patients, or 69.8%). The greatest relative number of questionable (or weakly positive) results of LLSR was found in patients with EPLT (17 of 54 patients, or 31.5%). The highest relative number of negative results of the LLSR- was for the time being the examination in DA of patients with DS TBL (9 of 66, or 13.6%). In patients with DS and MDR TBL, the total IgE level was 140.6±52.3 and 147.0±70.1 IU/ml, respectively. The highest level of IgE (172.0±68.1 IU/ml) was detected in patients with EPLT. Conclusion: Leukocytes reactions to incubation with anti-tuberculosis drugs (the fourth type of DA) was detected in 146 (89.6%) of patients with TB from 163 patients (LLSR+ and LLSR±), and the absence of this leukocyte reaction for all the drugs studied – in 17 (10.4%) of patients with TB from 163 surveyed with suspicion of DA (LLSR-). The highest level of IgE (172.0±68.1 IU/ml) was detected in patients with EPLT
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