{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:36:51Z","timestamp":1790692611097,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T00:00:00Z","timestamp":1516320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["SAF210\u201019867"],"award-info":[{"award-number":["SAF210\u201019867"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["FIS PI13\/01768"],"award-info":[{"award-number":["FIS PI13\/01768"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002924","name":"Federaci\u00f3n Espa\u00f1ola de Enfermedades Raras","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002924","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2018,3]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Drug reaction with eosinophilia and systemic symptoms (DRESS<\/jats:styled-content>) is a severe delayed hypersensitivity reaction. The determination of drug causality is complex. The lymphocyte transformation test (LTT<\/jats:styled-content>) has been reported positive in more than 50% of DRESS<\/jats:styled-content> cases. Nevertheless, the sensitivity and specificity of LTT<\/jats:styled-content> specifically in DRESS<\/jats:styled-content> have not yet been established. Rechallenge with the culprit drug is contraindicated and cannot be used as gold standard for sensitivity and specificity determination.<\/jats:p><\/jats:sec>Objective<\/jats:title>To estimate the sensitivity and specificity of LTT<\/jats:styled-content> in a clinically defined series of patients with DRESS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Some 41 patients diagnosed with DRESS<\/jats:styled-content> were included in the study. The results of the algorithm of the Spanish Pharmacovigilance System were used as the standard for a correct diagnosis of drug causality. A standard LTT<\/jats:styled-content> was performed with involved drugs in acute or recovery samples. A stimulation index (SI<\/jats:styled-content>) \u22652 in at least one concentration except for beta\u2010lactams (SI<\/jats:styled-content> \u22653) and contrast media (SI<\/jats:styled-content> \u22654) was considered positive. Contingency tables and ROC<\/jats:styled-content> curves were used for analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>Sensitivity and specificity of LTT<\/jats:styled-content> in the recovery phase of DRESS<\/jats:styled-content> were 73% and 82%, respectively, whereas in the acute phase, they were only 40% and 30%, respectively. Comparison of skin tests and LTT<\/jats:styled-content> confirmed a higher sensitivity and specificity of LTT<\/jats:styled-content> in DRESS<\/jats:styled-content>. LTT<\/jats:styled-content> showed high sensitivity (S) and specificity (Sp) for anticonvulsants (S 100%, Sp 100%; P\u00a0<\/jats:italic>=\u00a0.008), anti\u2010TB<\/jats:styled-content> drugs (S 87.5%, Sp 100%; P<\/jats:italic>\u00a0=\u00a0.004), and beta\u2010lactams (S 73%, Sp 100%; P<\/jats:italic>\u00a0=\u00a0.001). ROC<\/jats:styled-content> curves revealed that the best criteria for LTT<\/jats:styled-content> positivity for all drugs are SI<\/jats:styled-content> \u22652 in at least one concentration, increasing overall sensitivity to 80%, and for beta\u2010lactams from 73% to 92%.<\/jats:p><\/jats:sec>Conclusions and clinical relevance<\/jats:title>LTT<\/jats:styled-content> is a good diagnostic tool for drug causality in DRESS<\/jats:styled-content>, mainly when performed in the recovery phase.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.13076","type":"journal-article","created":{"date-parts":[[2017,12,19]],"date-time":"2017-12-19T07:02:39Z","timestamp":1513666959000},"page":"325-333","source":"Crossref","is-referenced-by-count":75,"title":["Sensitivity and specificity of the lymphocyte transformation test in drug reaction with eosinophilia and systemic symptoms causality assessment"],"prefix":"10.1111","volume":"48","author":[{"given":"R.","family":"Caba\u00f1as","sequence":"first","affiliation":[{"name":"Department of Allergy La Paz University Hospital Health Research Institute (IdiPAZ) Madrid Spain"},{"name":"PIELenRed Consortium Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Allergy La Paz University Hospital Health Research Institute (IdiPAZ) Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"PIELenRed Consortium Madrid Spain"},{"name":"Department of Clinical Pharmacology School of Medicine La Paz University Hospital Health Research Institute (IdiPAZ) Autonomous University of Madrid Madrid 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