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In vitro interferon-gamma release test in patients with drug-induced pemphigus
Ilan Goldberg1, Idit Shirazi, Sarah Brenner
1Department of Dermatology, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Background:
Drug-specific CD8+ TH1 lymphocytes have been found in the peripheral blood and involved skin of patients with drug-induced bullous exanthems.
Objectives:
To determine whether the interferon-gamma release test can identify culprit drugs in pemphigus patients.
Methods:
Clinical and laboratory workup for pemphigus was performed in 14 pemphigus vulgaris patients who had been exposed to drugs, and the IFN-gamma release test was conducted on their lymphocytes from heparinized venous blood cultured with medium, phytohemagglutinin and one of 32 drugs, or medium and phytohemagglutinin alone.
Results:
Ten of the patients and 13 of the 32 drugs exhibited a positive response to the test. Eight of the 10 patients with positive IFN-gamma test results had a less severe course of the disease, with fast reduction in steroid dosage.
Conclusions:
The findings demonstrate both the ability of the IFN-gamma release test to identify drugs that can induce pemphigus, and its usefulness in the diagnostic workup of pemphigus patients.
