A Novel System to Diagnose Cutaneous Adverse Drug Reactions Employing the Cellscan—Comparison with Histamine Releasing Test and Inf‐γ Releasing Test

Goldberg, Ilan; Gilburd, Boris; Kravitz, Martine Szyper; Kivity, Shmuel; Chaim, Berta Ben; Klein, Tirza; Schiffenbauer, Yael S.; Trubniykovr, Ela; Brenner, Sarah; Shoenfeld, Yehuda

doi:10.1080/10446670410001722230

Cited by 7 publications

(9 citation statements)

References 24 publications

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“…Due to the reemergence of generalized urticaria following the rechallenge with MMF, we concluded that the patient had developed the hypersensitivity reaction to MMF. In addition, the rechallenge with MMF confirmed the results suggested by the in vitro CellScan analysis [13]. …”

Section: Case Reportsupporting

confidence: 69%

“…Briefly, 20 ml of blood was collected and mononuclear cells were separated in a Ficoll gradient and incubated with the following suspected drugs: ofloxacin, clindamycin, plaquenil, MCR and MMF. Changes in fluorescence polarization were measured using the CellScan method [13]. Results were positive for ofloxacin and MMF, suggesting that these drugs may have been responsible for the urticaria.…”

Section: Case Reportmentioning

confidence: 99%

“…Methods and preliminary results have been published elsewhere [13]. Briefly, 20 ml of blood was collected and mononuclear cells were separated in a Ficoll gradient and incubated with the following suspected drugs: ofloxacin, clindamycin, plaquenil, MCR and MMF.…”

Section: Case Reportmentioning

confidence: 99%

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Hypersensitivity to Mycophenolate Mofetil in Systemic Lupus Erythematosus: Diagnostic Measures and Successful Desensitization

Szyper‐Kravitz

Sheinberg²,

Sidi³

et al. 2005

Int Arch Allergy Immunol

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Despite therapeutic advances in the treatment of systemic lupus erythematosus (SLE), several patients are still afflicted with severe and uncontrolled symptoms. Recently, mycophenolate mofetil (MMF) has been introduced in the treatment of SLE, with a significant therapeutic benefit, and minor side effects have been reported. Data on the adverse effects of MMF in SLE are lacking. We present an SLE patient who developed urticaria during MMF treatment. Rechallenge with MMF established the diagnosis of MMF-induced urticaria. As MMF was considered a necessary therapy, a desensitization protocol was devised, which successfully induced tolerance to MMF. This is the first published protocol for MMF desensitization, which induced tolerance in an SLE patient previously reacting with generalized urticaria.

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Section: Case Reportsupporting

confidence: 69%

Section: Case Reportmentioning

confidence: 99%

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Hypersensitivity to Mycophenolate Mofetil in Systemic Lupus Erythematosus: Diagnostic Measures and Successful Desensitization

Szyper‐Kravitz

Sheinberg²,

Sidi³

et al. 2005

Int Arch Allergy Immunol

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“…These preliminary findings illustrate the potential role for the CellScan in the detection of drugs responsible for adverse reactions. 30…”

Section: Monitoring Drug Efficacy and Drug-induced Hypersensitivitymentioning

confidence: 99%

Application of a Static Fluorescence-Based Cytometer: The Cellscan in Clinical Immunology

Szyper‐Kravitz

Harel

Gilburd

et al. 2006

Lupus

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The CellScan system is a laser scanning cytometer which enables repetitive fluorescence intensity (FI) and polarization (FP) measurements in living cells, as a means of monitoring lymphocyte activation. By monitoring FP changes in peripheral blood lymphocytes (PBL) following exposure to antigenic stimuli, the CellScan may have a role in the diagnosis of autoimmune diseases. Monitoring changes in FI and FP in PBLs from patients with atherosclerosis following exposure to various stimuli, has illustrated the role of the immune system in the atherosclerotic process. The CellScan has also been evaluated as a diagnostic tool for drug-induced allergy, based on FP reduction in PBLs following incubation with the suspected drugs. FI and FP changes in cancer cells have been found to correlate with the cytotoxic effect of different anti-neoplastic drugs, illustrating the potential role of the CellScan system in clinical oncology. In conclusion, the CellScan is a promising new tool with a variety of applications in cell biology, immunology, cancer research and clinical pharmacology.

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“…Since this system was first introduced by Deutsh and Weinreb in 1994 20 it has been widely used to detect activation of lymphocytes both in physiological 21 and pathological situations including cancer, autoimmune disorders and atherosclerosis 22–25 . In 2005, the Cellscan has been introduced as a novel in vitro test to diagnose cutaneous ADR 26,27 . Although its diagnostic potential has been demonstrated with sensitivity of 87% and specificity of 53%, the accuracy of the test has not been tested according to the type of drug, type of rash or clinical probability of patients for having a cutaneous adverse reaction.…”

Section: Introductionmentioning

confidence: 99%

Clinical application of static fluorescence‐based cytometry, Cellscan, in cutaneous adverse drug reaction

Salameh¹,

Kravitz

Barzilai³

et al. 2010

The Journal of Dermatology

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The aim of the present study was to evaluate the effectiveness of Cellscan in identifying culprit drugs causing cutaneous adverse drug reaction. It was a prospective study with 3 months follow up conducted at the Departments of Dermatology, Internal Medicine and Dermatology Outpatient Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel. The study included 36 patients with cutaneous reaction suspected to be secondary to drugs, treated with a total number of 148 drugs. All patients and drugs were classified to three probability groups according to accepted clinical criteria. The effectiveness of the Cellscan test in identifying the culprit drug was addressed according to the clinical probability for cutaneous drug reaction, the drug class and the type of rash. Data analysis according to the clinical probability for cutaneous drug reaction revealed that patients in the moderate and high probability groups had a high test sensitivity of 77.7% and 83.3% with specificity of 71% and 63%, respectively, in identifying the culprit drug. Classifying the data according to drug classes, revealed that for the antibiotic and cardiovascular drug classes the sensitivity of the test was 100% and 92% with specificity of 83.3% and 55.5%, respectively, in identifying the culprit drug. Finally, the classification of patients according to the type of rash revealed a high evaluating accuracy for culprit drugs in maculopapular rashes with sensitivity and specificity of 90% and 60.4%, respectively. The results of this study imply that the Cellscan test is it a good practical tool for identifying the culprit drug in cutaneous adverse drug reaction.

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A Novel System to Diagnose Cutaneous Adverse Drug Reactions Employing the Cellscan—Comparison with Histamine Releasing Test and Inf‐γ Releasing Test

Cited by 7 publications

References 24 publications

Hypersensitivity to Mycophenolate Mofetil in Systemic Lupus Erythematosus: Diagnostic Measures and Successful Desensitization

Hypersensitivity to Mycophenolate Mofetil in Systemic Lupus Erythematosus: Diagnostic Measures and Successful Desensitization

Application of a Static Fluorescence-Based Cytometer: The Cellscan in Clinical Immunology

Clinical application of static fluorescence‐based cytometry, Cellscan, in cutaneous adverse drug reaction

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