Diagnosis of Drug Induced Hepatitis by Whole Blood Microculture Technique

概要

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In order to ensure the in vitro diagnosis of drug-induced allergic hepatitis, a microvolumewhole blood culture technique was devised. In a settled experimental condition, clearlymphocyte transformation was observed in the whole blood culture when activated withmitogen, such as PHA or PWM. These were detected with either 3H-thymidine uptakeinto DNA or appearances of lymphoblastoid cells. More over MIF production was alsoconfirmed in this method when lymphocytes taken from the tuberculine-positive individualswere stimulated with PPD.The whole blood culture prepared from 57 patients who developped jaundice or liverinjury during the course of treatment with some drugs have shown the positive lymphocytetransformation to the drug.The causative drugs were 16 cases of antituberculotic drugs, 13 cases of antibiotics, 4cases of sulfa drugs, 4 cases of psycotherapeutic drugs and others. Eosinophilia wasobserved in 35.4% and high level of total bilirubin in serum was detected in 51.2%. Also, in most of patients (85.5%) who showed the positive blastogenesis, high levels oftransaminase (under 500 units) were revealed. Out of 18 cases who showed the positiveresponse, 13 cases were cholestatic type of liver injury.These results suggested the micro volume whole blood culture technique provide a usefulin vitro methodology to detect the drug induced allergic hepatitis because of requiring thevery small amount of blood.
財団法人日本消化器病学会の論文