Modifications of the lymphocyte transformation test in a case of drug-induced cholestatic hepatitis

We analyzed several factors that might influence the ability to detect lymphocyte sensitization to a drug by the lymphocyte transformation test in a patient with erythromycin ethylsuccinate cholestatic hepatitis. Weak lymphocyte reactivity to the drug was demonstrated in standard conditions, but this could be substantially increased in the presence of a prostaglandin inhibitor, providing evidence for the presence of prostaglandin-producing suppressor cells. In contrast, no evidence for short-lived suppressor cells influencing the drug reactivity was found. Reactivity to "drug metabolite containing serum" could by recorded when reactivity to the drug itself had disappeared. Such modifications of the lymphocyte transformation test may be of help in the in vitro diagnosis of drug hypersensitivity.