Volume 8 Supplement 1

3rd WAO International Scientific Conference (WISC) 2014

Open Access

Serum soluble fas ligand levels and peripheral blood lymphocyte subtypes in patients with drug induced maculopapular rashes, dress and viral exanthemas

  • Mehtap Yazicioglu1,
  • Burhan Turgut1 and
  • Pinar Gokmirza Ozdemir1
World Allergy Organization Journal20158(Suppl 1):A182

https://doi.org/10.1186/1939-4551-8-S1-A182

Published: 8 April 2015

Background

Fas/Fas ligand (FasL)-dependent apoptotic pathway was reported to be involved in the pathogenesis of drug induced maculopapular rashes (MPRs). In this study, we investigated serum soluble FasL level to discriminate drug-induced skin reactions from other clinically resembling skin diseases such as exanthematous viral infections. We also eveluated the role of T cells in various drug-induced diseases.

Methods

We analyzed 7 patients with drug induced MPRs (group I), 17 patients with viral exanthemas (group II), 6 paients with DRESS [grup III], and 15 healthy children with no history of adverse drug reactions. A complete blood count and immunophenotyping of peripheral blood lymphocytes were carried out, as well serum FasL levels were analyzed in group I-III (Human sFas-L ELISA kit, eBioscience, Vienna, Austria), within 2 days after the onset of the skin eruptions. Tests were repeated between days 3-5 and days 6-10. In group IV, these analyses were performed once. Liver and renal functions were also eveluated in group I-III. Serum immunoglobulin levels were analyzed in group 3. Skin tests with the suspected drug were applied in cases in group I and III according to the guidelines. In group II, skin tests, drug provocation tests, and viral serology were performed if needed.

Results

Absolute numbers of peripheral blood lymphocytes ans sFasL levels in initial samples of cases in 4 groups are summarized in Table 1.

Table 1

  

Group 1

Group 2

Group 3

Group 4

sFasL (ng/ml)

Mean±SD

0.20±0.14

0.24±0.16

0.22±0.16

0.19±0.21

 

Median

0.27

0.20

0.18

0.10

CD3+/CD4+ cells*

Mean±SD

1508±1230

1761±824

918±552

1240±347

 

Median

1026

1604

741

1212

CD3+/CD8+ cells*

Mean±SD

1735±1839

888±463

509±355

723±252

 

Median

1376

910

407

624

CD19+ cells*

Mean±SD

622±322

1049±659

195±181

535±286

 

Median

630

834

132

489

CD3)/CD16+/CD56+(NK cells)*

Mean±SD

151-980

264-3009

20-487

103-1241

 

Median

250±238

181±111

94±34

253±235

*Counts, cells/ml

B cell counts were low in group III when compared to group I and IV. CD4+cells, CD19+cells and NK cells were low in group III when compared to group II. There were no significant differences in sFasL levels between the groups.

Conclusions

In our study, sFasL levels were not found to be useful to discriminate viral exanthemas from drug rashes. Additionally, the results were not found to be different on repeated evaluations. The only significant difference between drug induced MPRs and DRESS was B cell counts. The low numbers of B cells in DRESS within the first 2 days of the symptoms might be a useful predictor of DRESS development.

Authors’ Affiliations

(1)
Trakya University

Copyright

© Yazicioglu et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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