Diagnosis of drug induced liver injury using a lymphocyte blast transformation test based on whole blood culture

Twenty cases of suspected drug induced liver injury (16 cases of which satisfied the criteria for at least a query positive diagnosis as based on the Fourth Congress of "Drugs and the Liver" in Japan) were studied by the whole blood culture technique of lumphocyte blast transformation. The positive rate with this technique was 10%, and no more than 15% even with the addition of one query positive. One reason for the low positive rate was that there was not only an allergic mechanism at work in the study group but that liver injury due to direct cytotoxicity of the drug was involved also. For a drug such as chlorpromazine with strong cytotoxicity for lymphocytes, it was difficult to demonstrate a relationship between allergic mechanisms and the drug with this method.