The predictive value of the lymphocyte transformation test in isoniazid-associated hepatitis

Authors

  • R. J. WARRINGTON,

    Corresponding author
    1. Departments of Medicine and Immunology, Faculty of Medicine, University of Manitoba and the Health Sciences Centre, Winnipeg, Manitoba
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  • SHAWN MCPHILIPS-FEENER,

    1. Departments of Medicine and Immunology, Faculty of Medicine, University of Manitoba and the Health Sciences Centre, Winnipeg, Manitoba
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  • W. J. RUTHERFORD

    1. Departments of Medicine and Immunology, Faculty of Medicine, University of Manitoba and the Health Sciences Centre, Winnipeg, Manitoba
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Dr R.J. Warrington, Section of Clinical Immunology, C319 General Centre, 700 William Avenue, Winnipeg, Manitoba R3E OZ3, Canada.

Summary

Sixty-one patients receiving isoniazid (INH) for chemotherapy or chemoprophylaxis were assessed by the lymphocyte-transformation test (LTT) shortly after starting treatment. Thirty-eight per cent exhibited stimulation with INH, isonicotinic acid (INA) or human-serum albumin conjugates of these haptens. In the LTT-positive group, liver dysfunction subsequently developed in 58-8%, as compared to 22-7% in the LTT-negative group (P <0.01). The difference was not accountable on the basis of age, ethnic background, sex or chemotherapy vs chemoprophylaxis. Although there was an excess of alcohol abusers in the LTT-positive group, the probability of developing liver dysfunction amongst alcohol abusers in that group was twice as great as for LTT-negative alcohol abusers. The specificity of the LTT in predicting liver damage was 83-90% (depending upon the criteria used for determining positivity), while the sensitivity of the test was only 50%.

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