Rapid immunochromatographic test for serum granulysin is useful for the prediction of Stevens-Johnson syndrome and toxic epidermal necrolysis - 28/07/11
, Junko Murata, MD, PhD a, Daichi Hoshina, MD a, Hirokatsu Mae, MS b, Hiroshi Shimizu, MD, PhD a
Reprint requests: Riichiro Abe, MD, PhD, Department of Dermatology, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo 060-8638, Japan.Abstract |
Background |
Life-threatening adverse drug reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) sometimes start with clinical features of ordinary drug-induced skin reactions (ODSRs) and it may be difficult to make a correct diagnosis before severe mucocutaneous erosions occur. We have reported that serum granulysin levels are elevated (cut off: 10 ng/mL) in patients with SJS/TEN before generalized blisters form.
Objective |
We sought to develop a rapid detection system for elevated serum granulysin to predict the progression from ODSRs.
Methods |
Serum samples from 5 patients with SJS/TEN at 2 to 4 days before mucocutaneous erosions formed were analyzed. Sera from 24 patients with ODSRs and 31 healthy volunteers were also investigated as control subjects. We developed a rapid immunochromatographic assay for the detection of high levels of serum granulysin using two different antigranulysin monoclonal antibodies.
Results |
The immunochromatographic test showed positive results for 4 of 5 patients with SJS/TEN but only one patient of 24 with ODSRs. The results correlated closely with those of enzyme-linked immunosorbent assays.
Limitations |
The validation of the long-time stability in this test strip has not been investigated.
Conclusion |
This novel test enables the prediction of SJS/TEN occurrence in patients even when only features of ODSRs are noted clinically.
Le texte complet de cet article est disponible en PDF.Key words : adverse drug eruption, diagnostic test, granulysin, Stevens-Johnson syndrome, toxic epidermal necrolysis
Abbreviations used : ODSRs, sFasL, SJS, TEN
Plan
| The first two authors contributed equally to this article. |
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| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 65 - N° 1
P. 65-68 - juillet 2011 Retour au numéro
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