Журнал клинических случаев

The Use of Lymphocyte Stimulation Test in Severe Nabumetone-Induced Stevens-Johnson Syndrome: A Case Report

Abstract

Rauno J Harvima1*, Ilkka T Harvima1, Antti Poso2, Jaana RRysä2 and Raimo Ojala3

The plausible causative role of nabumetone in severe Stevens-Johnson syndrome in a 27-year old healthy female was shown by the Lymphocyte Stimulation Test (LST). In 2 healthy controls, LST was negative, and nabumetone did not prevent lymphocyte stimulation by phytohemagglutinin. The positive LST is somewhat surprising, because the patient had not been exposed by the drug previously and already the first 2 tablets induced the reaction.

The results suggest that LST can be useful in the diagnostics of severe life-threatening drug reaction, but the use of multiple drug dilutions is necessary in the case of suspected antigen that possesses anti-inflammatory properties. It can be possible that the positive LST and clinical reaction are related to crossreactivity between anti-inflammatory analgesic drugs. Also it may be possible that even a short transient time of nabumetone in blood before biotransformation may trigger a severe drug reaction.