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Drug-Induced Allergic Cytopenia: In Vitro Confirmation by the Lymphocyte Transformation Test
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We want to continue the discussion on drug-induced agranulocytosis and neutropenia1-2 and point to the differentiation between underlying allergic or cytotoxic mechanisms that may be important: preventing allergic reactions usually requires avoidance of the culprit drug for a lifetime. The in vitro lymphocyte transformation test has proven more sensitive than skin tests for the diagnosis of drug allergy, and is effective regardless of the clinical phenotype of the reaction because drug-sensitized lymphocytes are found in antibody- or cellular-mediated immune reactions.3
Here we describe a 38-year-old man with Streptococcus viridans endocarditis of the mitral valve who began treatment with 80 mg of gentamicin 3 times daily and 2 g of ampicillin 3 times daily, which was changed on day 4 to 6 g of benzylpenicillin 3 times daily and 220 mg of gentamicin once daily. From day 22 on he developed a fever (39.8°C) and arthalgia. Cell counts gradually dropped and . . . [Full Text of this Article]
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