Dietary supplement product composed of natural ingredients as a suspected cause of erythema multiforme: a case report and identification for the confident false-positivity of lymphocyte transformation test.
Dietary supplement product composed of natural ingredients as a suspected cause of erythema multiforme: a case report and identification for the confident false-positivity of lymphocyte transformation test.
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由天然成分组成的膳食补充剂产品疑似引起多形红斑：淋巴细胞转化试验可信假阳性的病例报告和鉴定。
DOI：
10.1111/1346-8138.14739
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发表时间：
2019
影响因子：
3.1
通讯作者：
Natsuko Utsunomiya
中科院分区：
文献类型：
--
作者：
Satoshi Ebata;Ayumi Yoshizaki;Takemichi Fukasawa;Takasgi Yamashita;Shunsuke Miura;Ryosuke Saigusa;Megumi Hirabayashi;Asako Yoshizaki;Kaname Akamata;Yoshihide Asano;Yutaka Kazoe;Kazuma Mawatari;Takehiko Kitamori;Shinichi Sato;Natsuko Utsunomiya
Growing and sustainable consumption of health‐care products raises a controversial issue underlying the reliability of anin vitrodiagnostic approach for adverse skin reaction. This report aimed to: (i) discuss the causative nature of a commercial dietary supplement composed of natural ingredients, particularly anEuglena‐containing product, suspicious for erythema multiforme in our exemplified case; and (ii) to address the assay suitability of the lymphocyte transformation test (LTT) for identifying allergic reaction to any ingredient(s) of the product. A Japanese elderly man developed erythema multiforme after intake of a commercially available natural dietary product, whose LTT was positive. His clinical course and positive LTT suggested a provisional diagnosis of natural dietary product‐induced eruption. We conducted an inquiry survey for the standard LTT with any commercial products containingEuglenain three major Japanese laboratory services and identified 22 subjects, almost all of whom (21/22, 95.6%) showed a positive LTT for anyEuglena‐containing products as a suspected causative. Seven normal healthy volunteers who had no intake history ofEuglena‐containing products showed an equivalent LTT positivity rate with the same product taken by our case; culprit components of the product includedEuglena,Angelica keiskei, Barley grass andChlorella. A cell‐free culture system and enzyme‐linked immunoassay suggest that the high LTT positivity relies on the non‐specific lymphoproliferative activity, and not contamination of uncharacterized microorganisms and endotoxins. Because of the constitutive false positivity of LTT, this assay is unreliable forin vitrosupportive diagnosis of adverse skin events caused by dietary products containing particular natural ingredients, as well as herbal materials.
