Application of laboratory methods for determining hypersensitivity to antuberculosis drugs in patients with pulmonary tuberculosis

Abstract

To date, there are no unified and standardized laboratory methods for the diagnosis of hypersensitivity to anti-TB drugs.Objective — to establish the most informative available in vitro immunolo-gical tests to determine the sensitivity to anti-TB drugs in patients with pulmonary tuberculosis.Materials and methods. Clinical and immunological examination was carried out in 36 patients with pulmonary tuberculosis, which were divided into two groups: 1 — with the presence of typical clinical manifestations of hypersensitivity to anti-TB drugs; 2 — without visible clinical signs of hypersensitivity. The tests were performed to detect intolerance to first-line anti-TB drugs in vitro: inhibition of lymphocyte migration, neutrophil alteration, inhibition of the adhesive ability of polymorphic nuclear leukocytes to plastic, release of potassium ions by blood leukocytes, erythrocyte sedimentation reaction.Results and discussion. A higher frequency of detecting positive reactions with anti-TB drugs was established in tests of neutrophilocyte alteration and erythrocyte sedimentation. Patients of the 1st group showed higher levels on average: serum tryptase, intensities of alteration of neutrophilic granulocytes, sedimentation values of red blood cells with anti-TB drugs at the 3rd and 24th hours.Conclusions. The most informative tests to determine the unpredictable reactions of drug intolerance in TB patients were the neutrophil alteration test and the sedimentation test of red blood cells with anti-tuberculosis drugs. The use of these tests can help to understand the pathogenesis of drug hypersensitivity in each case.