Abstract
For studies on the pathogenesis of drug eruptions related to gold sodium thiomalate (GST), the lymphocyte transformation test (LTT) to GST was performed in patients with rheumatoid arthritis (RA). RA patients who developed some form of drug eruptions during the treatment with GST and, as controls, RA patients who had undergone no treatment with GST served as the subjects under study. LTT was done on three groups in the presence of GST, PHA or both GST and PHA. All the tests were made using the whole blood culture method. Of 11 patients with drug eruptions, two showed a positive results in LTT to GST. LTT to PHA exhibited marked reduction in blastoid transformation in most patients, but no difference was noted between the patients with drug eruptions and the controls. LTT to PHA added GST, also caused a reduction in blastoid transformation. However, correlations between the increased serum gold level and the reduced blastoid transformation in LTT to PHA were not evident, thereby indicating the suppression of lymphocyte function in the RA patients. Consequently it was considered that GST-induced lymphocyte transformation was a specific reaction and would occur at a significant level even under conditions in which the lymphocyte function is suppresses. Cell-mediated immunity may be involved in some cases of drug eruptions due to GST.
