Background: Multiple drug allergy syndrome is a clinical condition characterized by reactions against more than one different class of, both pharmacologically and structurally, unrelated drugs. Scanty data are available to date about a multiple drug delayed hypersensitivity syndrome. Our aim was to report the case of a delayed reaction to both β-methasone (β-MT) and penicillin-G (pen-G) occurring in the same patient, and analyse β-MT- and pen-G-specific T-cell Lines (TCLs) with regard to their specificity, phenotype and cytokine profile. Methods: We generated two drug-specific TCLs from biopsies at the site of positive intradermal reactions, and analysed their immunophenotype, T-cell receptor Vβ (TCR-Vβ) domains expression and cytokine profile. Results: We demonstrated the specificity of the T cells isolated from positive intradermal test reactions to pen-G and β-MT through the strict dose-dependent proliferation in response to drug-pulsed autologous antigen presenting cells. Fluorescence activated cell sorter (FACS) analysis revealed a predominance of CD4 + cells in the inflammatory cell infiltrate of intradermal test with β-MT, while a predominance of CD8 + T cells in the site of delayed reaction to pen-G was found. The drug specific CD4 + and CD8 + T cells were heterogeneous, with regard to TCR-Vβ usage. CD8 + pen-G-TCL displayed a preferential T helper 2 (Th2) profile, while a substantially heterogeneous pattern of cytokine production characterized specific β-MT TCL. Conclusion: The study describes the coexistence in the same patient of a delayed hypersensitivity to both penicillin G and β-MT, driven, respectively, by pen-G-specificTh2-skewed CD8 + and β-MT specificTh0 CD4 + T cells. This case further support the existence of a multiple drug allergy syndrome also for delayed hypersensitivity.
|Number of pages||6|
|Journal||Allergy: European Journal of Allergy and Clinical Immunology|
|Publication status||Published - May 1 2003|
- Delayed allergy
- Drug allergy
ASJC Scopus subject areas