Lymphocyte Transformation Test (LTT) in allergy to benznidazole: A promising approach
Entidad
UAM. Departamento de Farmacología; UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)Editor
Frontiers MediaFecha de edición
2019-05-21Cita
10.3389/fphar.2019.00469
Frontiers in Pharmacology 10.May (2019): 469
ISSN
1663-9812DOI
10.3389/fphar.2019.00469Financiado por
This work was funded by FIS PI13/01768 to TBVersión del editor
https://doi.org/10.3389/fphar.2019.00469Materias
Benznidazole allergy; Lymphocyte transformation test; Drug allergy; Delayed hypersensitivity; Benznidazole; Benznidazole sensitivity; MedicinaDerechos
© 2019 Marques-Mejías, Cabañas, Ramírez, Domínguez-Ortega, Fiandor, Trigo, Quirce and Bellón.Resumen
Benznidazole (Bzn) from the nitroimidazole family and nifurtimox from nitrofurans family,
are drugs used as first and second line treatment for acute and chronic phases of
Chagas disease (CD). Even though skin reactions are frequent, confirmed allergy to
Bzn is rare, and there are few cases reported in the literature. Since CD treatment is
very restrained, the possibility of cross-reactivity between members of the same and
other pharmacological families highlights the importance of an adequate diagnosis that
allows alternative treatments in CD and other diseases. We report a series of 31 patients
(69% women) referred to our Allergy unit with suspected hypersensitivity to Bzn, twenty
three of them with mild reactions and eight of them with severe reactions. LTT with Bzn
was performed in 31 patients and in 8 negative controls. LTT was also performed in 25
and 20 of these patients with nifurtimox and Mtn, respectively. Twenty-one out of thirtyone
patients were Bzn prick tested, and all were negative. We obtained 2/19 positive
results on patch tests to Bzn. LTT with Bzn was positive in 22/31 patients (Sensitivity
75.9% and specificity 100%). The test was considered positive with a stimulation index
2. There was a positive result in 7/25 patients for nifurtimox and in 7/20 patients with
Mtn. After negative LTT and skin tests, oral provocation was performed in 4/9 patients,
all negative. LTT is a safe test that seems to be more useful than skin tests (prick and
patch test), particularly in severe reactions, in confirming delayed hypersensitivity to Bzn
and detecting cross reactivity with other imidazoles such as Mtn and reactivity to other
drugs like nifurtimox. Tests for these drugs need to be included in the workup of patients
with hypersensitivity to Bzn in case they are needed as an alternative treatment for CD
or to treat other frequent infectious diseases.
Lista de ficheros
Google Scholar:Marques-Mejías, Andreína
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Cabañas, Rosario
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Ramírez García, Elena
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Domínguez-Ortega, Javier
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Fiandor, Ana
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Trigo, Elena
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Quirce Gancedo, Santiago Eugenio
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Bellón, Teresa
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