Assessment of drug causality in SJS/TEN: Concordance between lymphocyte transformation test and ALDEN
Assessment of drug causality in SJS/TEN: Concordance between lymphocyte transformation test and ALDEN
复制标题
DOI：
10.1111/all.14062
复制
发表时间：
2019-10-21
期刊：
影响因子：
12.4
通讯作者：
de Abajo, Francisco J.
中科院分区：
文献类型：
--
作者：
Bellon, Teresa;Rodriguez-Martin, Sara;de Abajo, Francisco J.
Stevens-Johnson综合征/中毒性表皮坏死松解症（SJS/TEN）是最严重的药物性皮肤不良反应（SCAR）。[1]高死亡率和致残后遗症突出了其临床意义。[[1]严重药物性皮肤不良反应是T细胞介导的超敏反应。[3]在大约80%的SJS/TEN病例中可以确定诱发药物。[4]别嘌呤醇、芳香族抗癫痫药、抗菌磺胺类药物和柳氮磺胺吡啶常与此相关，尽管可能涉及多种药物。[5]及时停用罪魁祸首药物是SJS/TEN治疗的核心。[1]然而，它的识别往往是困难的，特别是在多药的主题。[3]表皮坏死松解症（奥尔登）的药物因果关系算法是一种在社区获得病例中验证的6项评分系统，将每种药物的总评分转换为概率类别（< 0：非常不可能; 0-1：不太可能; 2-3：可能; 4-5：很可能;>= 6：非常可能）。[6]体内和体外诊断测试也可用于识别罪魁祸首药物。包括所有药物的ROC曲线分析表明，LTT在SJS/TEN恢复后区分罪犯药物和非罪犯药物的诊断能力良好（AUC=. 808）（图S3）。我们的研究结果表明，LTT可以帮助药物因果关系的评估后恢复的患者谁开发SJS/TEN后服用多种药物。[摘自文章]过敏的版权是威利-布莱克威尔的财产，其内容不得复制或通过电子邮件发送到多个网站或张贴到一个列表服务器未经版权保持器的明确书面许可。但是，用户可以打印，下载或电子邮件文章供个人使用。这篇摘要可以删节。不保证副本的准确性。用户应参考原始出版版本的材料的完整摘要。版权适用于所有摘要。
Abstract To the Editor, Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is the most severe drug-induced cutaneous adverse reaction (SCAR).[1] The high mortality and disabling sequelae highlight its clinical relevance.[[1],[3]] Severe drug-induced cutaneous adverse reactions are T cell-mediated hypersensitivity reactions.[3] An eliciting drug can be identified in approximately 80% of SJS/TEN cases.[4] Allopurinol, aromatic antiepileptics, antibacterial sulfonamides, and sulfasalazine are frequently associated, although a great variety of medications might be involved.[5] Prompt withdrawal of the culprit drug is the core of treatment in SJS/TEN.[1] However, its identification is often difficult, especially in polymedicated subjects.[3] The algorithm of drug causality for epidermal necrolysis (ALDEN) is a 6-item scoring system validated in community-acquired cases, which translates the total score assigned to each drug into a probability category (< 0: very unlikely; 0-1: unlikely; 2-3: possible; 4-5: probable; and >= 6: very probable).[6] In vivo and in vitro diagnostic tests can also be used to identify the culprit drugs. A ROC curve analysis including all drugs suggests a good diagnostic capacity of LTT to discriminate culprit from nonculprit drugs after recovery in SJS/TEN (AUC=. 808)(Figure S3). Our results suggest that LTT can be helpful for drug causality evaluation after recovery in patients who developed SJS/TEN after taking multiple medications.[Extracted from the article]Copyright of Allergy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. Copyright applies to all Abstracts.