Lymphocyte Transformation Test is unreliable for the diagnosis of kampo-medicine-induced liver injury.

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To examine actual impact of mitogenic activity by Kampo medicine on the lymphocyte transformation test(LTT), we conducted LTT for four herbs in patients who had taken no Kampo medicine in their life and consulted our department for the first time. Fourteen patients were enrolled for Toki (Angelicae Radix) and Ogon (Scutellariae Radix), and 4 patients were enrolled for Saiko (Bupleuri Radix) and Kanzo (Glycyrrhizae Radix). Patients who were being treated with corticosteroids or immunosuppresive drugs or who had experienced drug allergy were excluded. Each herb (5g) was added to 600 ml of water and boiled for 30 min. The boiled-down extract was submitted to Bio Medical Laboratories (BML, Inc.Japan), along with blood samples obtained from the enrolled patients. To examine the effects of herbs under the actual conditions of the LTT in the clinical situation, measurement of LTTs were performed as described previously ^<2)>by BML, Inc.LTT for both Toki and Ogon were positive in 12 of 14 patients. LTT for Saiko was positive in all 4 patients and LTT for Kanzo was positive in 3 of 4 patients. No eosinophilia or liver injury was observed in the patients. In the present study, we conducted LTT for these herbs in patients who had taken no Kampo medicine in their life. These findings suggests that LTT for the herbs are likely to yield false-positive results and LTT is unreliable for the diagnosis of Kampo-medicine-induced liver injury.