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薬剤性肝障害患者における原因薬剤同定における白血球遊走試験の臨床的応用と新しい診断基準(発表論文抄録(2007)) Clinical application of the leukocyte migration test and new diagnostic criteria for identifying causative agents in patients with drug-induced liver injury. 薄井, 健介 小田, 義貞 久保田, 理恵 根岸, 健一 宇野, 勝次 恒松, 聡 熊谷, 直樹 小宮山, 貴子 Adult Age Factors Aged Aged, 80 and over Cell Migration Assays, Leukocyte Cell Movement Drug-Induced Liver Injury Female Humans Leukocytes Leukocytes, Mononuclear Liver Liver Diseases Male Middle Aged Treatment Outcome We examined the usefulness of the leukocyte migration test (LMT) in the identification of agents causing drug-induced liver injury (DILI). In 14 patients who were tentatively diagnosed as having DILI in Kitasato Institute Hospital, pharmacists collected and evaluated drug information and patients' medication histories to identify causative agents. Simultaneously, LMT and drug lymphocyte stimulation test (DLST) were performed. Furthermore, scoring was performed according to the diagnostic criteria established by the International Consensus Meeting (ICM) and the Digestive Disease Week-Japan 2004 (DDW-J). LMT-positive agents showed a higher ICM score compared to DLST-positive agents. The rate of LMT-positive agents was examined with respect to ICM assessment, and 0%, 25%, 33%, and 100% of agents regarded as unrelated/unlikely, possible, probable, and highly probable showed positive reactions on LMT, respectively; the rate of LMT-positive agents increased with the degree of the agent's involvement. When the results of LMT were applied to the DDW-J criteria, there was a correlation with the ICM criteria in comparison to scoring based on the results of DLST. LMT may be useful for identifying agents causing DILI. Furthermore, the collection and evaluation of drug and patient information and in vitro testing in the identification of causative agents may support more reliable diagnosis. We examined the usefulness of the leukocyte migration test (LMT) in the identification of agents causing drug-induced liver injury (DILI). In 14 patients who were tentatively diagnosed as having DILI in Kitasato Institute Hospital, pharmacists collected and evaluated drug information and patients' medication histories to identify causative agents. Simultaneously, LMT and drug lymphocyte stimulation test (DLST) were performed. Furthermore, scoring was performed according to the diagnostic criteria established by the International Consensus Meeting (ICM) and the Digestive Disease Week-Japan 2004 (DDW-J). LMT-positive agents showed a higher ICM score compared to DLST-positive agents. The rate of LMT-positive agents was examined with respect to ICM assessment, and 0%, 25%, 33%, and 100% of agents regarded as unrelated/unlikely, possible, probable, and highly probable showed positive reactions on LMT, respectively; the rate of LMT-positive agents increased with the degree of the agent's involvement. When the results of LMT were applied to the DDW-J criteria, there was a correlation with the ICM criteria in comparison to scoring based on the results of DLST. LMT may be useful for identifying agents causing DILI. Furthermore, the collection and evaluation of drug and patient information and in vitro testing in the identification of causative agents may support more reliable diagnosis. 福山大学薬学部 2008-12-25 eng departmental bulletin paper https://fukuyama-u.repo.nii.ac.jp/records/8547 AN10064550 0288-724X 福山大学薬学部研究年報 Annual report of the Faculty of Pharmacy & Pharmaceutical Sciences, Fukuyama University 26 63 64 https://fukuyama-u.repo.nii.ac.jp/record/8547/files/63 薬剤性肝障害患者における.pdf application/pdf 143.9 kB 2016-12-01