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Original Research: TUBERCULOSIS |

Drug Lymphocyte Stimulation Test in the Diagnosis of Adverse Reactions to Antituberculosis Drugs

Yuzo Suzuki, MD; Seiichi Miwa, MD, PhD; Masahiro Shirai, MD, PhD; Hisano Ohba, MD; Miho Murakami, MD; Kaoru Fujita, MD; Takafumi Suda, MD, PhD; Hirotoshi Nakamura, MD, PhD; Hiroshi Hayakawa, MD, PhD; Kingo Chida, MD, PhD
Author and Funding Information

*From the Second Division (Drs. Suzuki, Suda, Nakamura, and Chida), Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan; and Department of Respiratory Medicine (Drs. Miwa, Shirai, Ohba, Murakami, Fujita, and Hayakawa), Tenryu Hospital, National Hospital Organization, Hamamatsu, Japan.

Correspondence to: Seiichi Miwa, MD, PhD, 4201-21 Oro, Hamamatsu, 434-8511, Japan; e-mail: hirosei@za.tnc.ne.jp

†These authors contributed equally to this work.


The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(5):1027-1032. doi:10.1378/chest.07-3088
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Background:  Tuberculosis (TB) is a worldwide infectious disease. Recently, standard therapy has become very effective for treating patients with TB; however, as a result of this powerful regimen, serious side effects have become an important problem. The aim of this prospective study was to evaluate the usefulness of the drug lymphocyte stimulation test (DLST) to determine anti-TB drugs causing side effects.

Method:  Four hundred thirty-six patients with TB were admitted to our hospital for treatment between January 2002 and August 2007. DLST was performed in patients who had certain adverse drug reactions during TB treatment. The causative drug was identified by the drug provocation test (DPT). The tested drugs were mainly isoniazid (INH), rifampin (RIF), ethambutol (EMB) and pyrazinamide (PZA).

Results:  Of 436 patients, 69 patients (15.8%) had certain adverse drug reactions to anti-TB drugs. Of the 261 agents that underwent the DLST and DPT, 28 agents (10.7%) in 20 patients (28.9%) were positive by DLST, and 67 agents (25.7%) in 46 patients (66.6%) were identified as causative drugs by DPT. The sensitivity of DLST was only 14.9% for all drugs (INH, 14.3%; RIF, 13.6%; EMB, 14.3%; PZA, 0%).

Conclusions:  DLST offers little contribution to the detection of causative agents in patients with adverse anti-TB drug reactions.

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