Abstract
Objective To explore the clinical value of the specific plasma cell detection and specific T lymphocyte detection test in diagnosing hypersensitivity caused by antituberculosis drugs. Methods A total of 266 patients with pulmonary tuberculosis who developed hypersensitivity during the treatment of primary pulmonary tuberculosis in our hospital and 266 patients without hypersensitivity during the treatment of pulmonary tuberculosis in our hospital were selected as the control group. The admission time is from January 2013 to June 2020. The specific plasma cell test and specific T lymphocyte test were used as the criteria to determine which drugs induced hypersensitivity, and the diagnostic value of these two methods in the diagnosis of hypersensitivity induced by four first-line antituberculosis drugs (isoniazid (INH), ethambutol (EMB), rifampicin (RFP), and pyrazinamide (PZA)) was analyzed. Results The sensitivity of the specific plasma cell test in the diagnosis of hypersensitivity induced by INH, EMB, RFP, and PZA was 63.42%, 51.20%, 47.81%, and 56.37%, respectively, and the specificity was 95.33%, 99.87%, 96.52%, and 99.99%, respectively. The sensitivity of the specific T lymphocyte test in the diagnosis of hypersensitivity induced by INH, EMB, RFP, and PZA was 66.47%, 52.88%, 49.91%, and 58.54%, respectively, and the specificity was 97.28%, 99.99%, 98.38%, and 100.00%, respectively. Conclusion The specific plasma cell test and specific T lymphocyte test have high specificity in the diagnosis of hypersensitivity caused by antituberculosis drugs, and the specific T lymphocyte test is better than the specific plasma cell test. It is of great significance to guide the clinical application of antituberculosis drugs.
Highlights
Tuberculosis is one of the infectious diseases that threaten human health [1]
China has the second largest TB burden in the world [15], How to quickly, safely, and accurately identify drugs that cause hypersensitivity reactions is a problem that clinicians urgently need to solve. e purpose of this study is to explore the sensitivity and specificity of the specific plasma cell test and specific T lymphocyte test in the diagnosis of antituberculosis druginduced hypersensitivity, so as to lay a foundation for the comprehensive in vitro detection of antituberculosis druginduced hypersensitivity in the future
A total of 272 cases of antituberculosis drug-induced hypersensitivity were detected by DPT (4 cases were caused by EMB, PZA, and RFP and 2 cases were induced by EMB and RFP)
Summary
Tuberculosis is one of the infectious diseases that threaten human health [1]. According to WHO statistics, there were 10.4 million new tuberculosis cases worldwide before 2016, with about 1.6 million deaths [2]. China is still one of the 30 countries with high TB burden in the world [3], with about 900000 new TB patients every year, ranking third in the world [4]. The standard treatment regimen consisting of isoniazid (INH), rifampicin (RFP), ethambutol (EMB), and pyrazinamide (PZA) can effectively treat most newly diagnosed tuberculosis patients [5, 6]. These antituberculosis chemical drugs may cause a variety of adverse reactions. Hypersensitivity is one of the common adverse reactions, which is often called drug allergy in clinics [7,8,9]. It is still of great significance to guide the clinical use of drugs
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