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Table 3 XTT–LTT results for the 10 patients enrolled in the study

From: Development and initial validation of a modified lymphocyte transformation test (LTT) assay in patients with DRESS and AGEP

Patient

Implicated and culprit drugs

Cells per well

One way ANOVA

Stimulation Index (> 2 positive, < 2 negative)

Cytokines (pg/ml)

IL2

IL4

IL5

P1

Vancomycin

200,000

Vancomycin 100 µg/ml *

Vancomycin 100 µg/ml (2.57)

− ve

− ve

0.3

P2 †

Piperacillin/Tazobactam (Tazocin)

Ceftriaxone (NEG)

Ceftotaxime (NEG)

Cefazolin (NEG)

Ceftazidime (NEG)

Amoxyicillin (NEG)

Benzylpenicillin (NEG)

153.000

Piperacillin/Tazobactam (Tazocin) 100 µg/ml*

Piperacillin/Tazobactam (Tazocin) 100 µg/ml (2.33)

− ve

− ve

15–50

P3 †

Sulphasalazine

Sulfapyridine

Sulfamethoxazole

Sulfamethoxazole + trimethoprim

200,000

Sulphasalazine (50 µg/ml***, 25 µg/ml* and 12.5 µg/ml***

Sulfapyridine 12.5 µg/ml*, 6.25 µg/ml** 3.12 µg/ml**

Sulfamethoxazole 100 µg/ml**, 50 µg/ml***

Sulfamethoxazole + trimethoprim (NS)

Sulphasalazine 100 µg/ml (2.2)

50 µg/ml (3.3), 25 µg/ml (2.6), 12.5 µg/ml (3.3)

Sulfapyridine12.5 µg/ml (2.55), 6.25 µg/ml (2.9), 3.12 µg/ml (2.97)

Sulfamethoxazole 100 µg/ml (3.78), 50 µg/ml (2.66), 25 µg/ml (2.13)

Sulfamethoxazole + trimethoprim

50 µg/ml (2.46), 25 µg/ml (2.0)

− ve

0.44

2–5

P4 †

Allopurinol

Oxypurinol

200,000

Allopurinol 25 µg/ml*

Oxypurinol 3.1 µg/ml*

Allopurinol 100 µg/ml (2.19)

25 µg/ml (2.63), 12.5 µg/ml (2.15)

− ve

− ve

− ve

P5 †

Sulphasalazine

 Sulfapyridine (NEG)

 Sulfamethoxazole (NEG)

 Sulfamethoxazole + trimethoprim (NEG)

170,000

Sulphasalazine (25 µg/ml*)

Sulphasalazine 25 µg/ml (4.97)

− ve

− ve

− ve

P6

Apixaban

200,000

Apixaban (25 µg/ml**,12.5 µg/ml**, 6.25 µg/ml and 3.1 µg/ml)

Apixaban All SI < 2

NT

NT

NT

P7 †

Piperacillin/Tazobactam (Tazocin)

186,000

Piperacillin/Tazobactam (Tazocin) (100 µg/ml*** and 6.25 µg/ml*)

Piperacillin/Tazobactam (Tazocin) 100 µg/ml (3.16)

6.25 µg/ml (2.45)

− ve

− ve

5–10

P8 †

Amoxicillin + clavulanic acid

 Amoxicillin (NEG)

200,000

Amoxicillin + clavulanic acid (NS)

Amoxicillin + clavulanic acid

 25 µg/ml (2.43)

− ve

0.3–0.7

0.5–2.4 l

P9

Lenalidomide

 Allopurinol (NEG)

 Oxypurinol (NEG)

200,000

Lenalidomide (50 µg/ml* and 6.25 µg/ml*)

Lenalidomide SI < 2

− ve

NT

NT

P10

Benzylpenicillin

Flucloxacillin

Ceftazolin-AFT

200,000

Benzylpenicillin (NS)

Flucloxacillin (NS)

Ceftazolin-AFT

 3.12 µg/ml*

Benzylpenicillin

 12.5 µg/ml (3.75), 6.25 µg/ml (3.56)

Flucloxacillin

 25 µg/ml (4.03), 12,5 µg/ml (3.3), 6.25 µg/ml (3.45), 3.12 µg/ml (3.14)

Ceftazolin-AFT

 50 µg/ml (3.44), 12.5 µg/ml (2.5), 6.25 µg/ml (3.66), 3.12 µg/ml (4.02)

− ve

NT

NT

  1. NS Not significant, NT = Not tested, − ve/NEG = Negative, ANOVA * p < 0.05, ** p < 0.01 and *** p < 0.001
  2. SI greater > 2 positive
  3. Age and sex matched control with no history of reactivity to drug performed for this patient All were negative