Intest Res  
Evaluation of the drug-induced lymphocyte stimulation test for diagnosing mesalazine allergy
Daisuke Saito, Mari Hayashida, Taro Sato, Shintaro Minowa, Osamu Ikezaki, Tatsuya Mitsui, Miki Miura, Akihito Sakuraba, Tadakazu Hisamatsu
The Third Department of Internal Medicine, Kyorin University School of Medicine, Mitaka, Japan
Correspondence to: Tadakazu Hisamatsu, The Third Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka 181-8611, Japan. Tel: +81-422-47-5511 (ext. 5279), Fax: +81-422-71-5381, E-mail: thisamatsu@ks.kyorin-u.ac.jp
Received: August 11, 2017; Revised: October 7, 2017; Accepted: October 8, 2017; Published online: December 1, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: Mesalazine is an effective drug for treating ulcerative colitis (UC), but causes allergic symptoms in a few cases. Therefore, the objective of this study was to evaluate the usefulness of the drug-induced lymphocyte stimulation test (DLST) for the diagnosis of mesalazine allergy. Methods: Patients with UC treated with mesalazine with or without a history of associated adverse events (AEs) were enrolled at Kyorin University Hospital from July 2016 to April 2017. Results: The DLST was performed in 104 patients with UC, of which 24 had a history of AEs due to mesalazine treatment. The control value of DLST was 337.4±296.3 counts per minute (cpm) in the AE+ group and 408.0±371.9 cpm in the AE group. The measured value of DLST was 578.8±424.7 cpm in the AE+ group and 476.5±471.8 cpm in the AE group. The stimulation index (SI) was 243.9%±291.1% in the AE+ group and 119.8%±53.0% in the AE group. The SI value and DLST positivity were significantly higher in the AE+ group than in the AE group (P=0.030 and P=0.029, respectively). The test sensitivity and specificity were 0.240 and 0.805, respectively, and the false-positive and false-negative rate was 0.195 and 0.760, respectively. Conclusions: The DLST for mesalazine showed low sensitivity and high specificity, suggesting that it may be useful for the definitive diagnosis of allergy to mesalazine.
Keywords: Mesalamine; Drug-induced lymphocyte stimulation test; Colitis, ulcerative


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