Review Article

In Vitro Assays for Diagnosis of Drug-Induced Nonsevere Exanthemas: A Systematic Review and Meta-Analysis

Table 1

Characteristics of primary studies included in the systematic review.

ReferenceCountry participantsParticipants’ age groupSettingSampling methodPerformed testsDrug participants reported to be allergic

Studies conducted in children population
Caubet et al. [17]Switzerland30ChildrenPatients (not specified)Convenience sampleLTT, BATBeta-lactams
Chopra et al. [18]Canada11ChildrenPatients (not specified)RetrospectiveLTTAmoxicillin
Tsuge et al. [19]Japan18ChildrenPatients (not specified)Convenience sampleCD4+ cell proliferation, IFN-γ secretionPhenytoin
Haw et al. [40]United Kingdom16Children and adultsPatients (not specified)RetrospectiveLymphocyte proliferation assay (LPA), combination of cytokine assaysn/a

Studies conducted in children and adult population
Ban et al. [20]Korea12Children and adultsInpatients and outpatientsConvenience sampleLTTFirst-line antituberculosis medication (isoniazid, ethambutol, rifampin, and pyrazinamide)
Fu et al. [21]China6Children and adultsPatients (not specified)Convenience sampleLTTCarbamazepine, acetaminophen, amoxicillin, penicillin, and cephazolin
Karami et al. [22]Iran48Children and adultsPatients (not specified)Consecutive sampleLTTAnticonvulsant (phenobarbital, phenytoin, carbamazepine, and lamotrigine)
Orasch et al. [23]Switzerland20Children and adultsPatients (not specified)Convenience sampleLTTLocal anaesthetics
Polak et al. [24]United Kingdom57Children and adultsPatients (not specified)Convenience sampleELISpot (IFN-γ, IL-4), LTTMultiple drugs
Sachs et al. [29]Germany20Children and adultsPatients (not specified)Consecutive sampleELISA (IL-5, IL-10, and IFN-γ), LTTMultiple drugs

Studies conducted in adult population
Abuaf et al. [30]France20AdultsPatients (not specified)Convenience sampleBATAmoxicillin
Ben-Said et al. [31]France56AdultsPatients (not specified)Convenience sampleIFN-γ ELISpotBeta-lactams
Halevy and Grossman [32]Israel12AdultsPatients (not specified)Convenience sampleIFN-γ release testMultiple drugs
Harenberg et al. [33]Germany9AdultsPatients (not specified)Convenience sampleIntracutaneous tests, HIPA assay, and heparin-induced IgG assayLMW heparin
Hari et al. [34]Switzerland22AdultsInpatients and outpatientsConvenience sampleLTTMultiple drugs
Kalish et al. [35]USA17AdultsPatients (not specified)Convenience sampleLTTTrimethoprim-sulfamethoxazole, sulfapyridine, hydrochlorothiazide, and furosemide
Lopez et al. [36]Spain16AdultsPatients (not specified)Convenience sampleLTTHeparins
Luque et al. [37]Spain47AdultsPatients (not specified)Convenience sampleRAST, LTTBeta-lactams
Ónodi-Nagy et al. [38]Hungary10AdultsPatients (not specified)Convenience sampleLTTPenicillins (amoxicillin, clavulanic acid, and cefixime)
Porebski and Czarnobilska [42]Poland47AdultsPatients (not specified)Convenience sampleELISpot assay, cytometric analysis, LTT, ELISAAntiepileptic drugs (carbamazepine, oxcarbazepine, lamotrigine, and phenytoin)
Porebski et al. [41]Poland32AdultsPatients (not specified)Convenience sampleElectrochemiluminescence assay (ECL), IFN-γ-ELISpot, LTT, IFN-γ-FACS, and IFN-γ-ELISAAntiepileptic drugs (carbamazepine, oxcarbazepine, and lamotrigine)
Rodriguez-Pena et al. [43]Spain17AdultsPatients (not specified)Convenience sampleLTTAmoxicillin
Romano [44]Italy24AdultsPatients (not specified)Convenience sampleRASTAminopenicillins
Schmid et al. [45]Switzerland6AdultsPatients (not specified)Convenience sampleLTTQuinolones (ciprofloxacin, norfloxacin, moxifloxacin)
Schnyder and Pichler [46]Switzerland12AdultsPatients (not specified)Convenience sampleCAP, LTTAmoxicillin and penicillin G
Srinoulprasert and Pichler [48]Switzerland6AdultsPatients (not specified)Convenience sampleModified LTT, LTTAmoxicillin, sulfamethoxazole, clavulanic acid, trimethoprim, and iomeron
Tanvarasethee et al. [49]Bangkok25AdultsPatients (not specified)Convenience sampleELISpotCeftriaxone, ceftazidime
Trautmann et al. [47]Germany37AdultsPatients (not specified)Convenience sampleModified LTT, LTTBeta-lactams
Whitaker et al. [39]United Kingdom39AdultsPatients (not specified)Convenience sampleLTTPiperacillin

Studies conducted in unknown population
Nyfeler and Pichler [25]Switzerland102n/aPatients (not specified)RetrospectiveLTTMultiple drugs
Rozieres et al. [26]France38n/aPatients (not specified)Convenience sampleIFN-γ ELISpot, LTTAmoxicillin, ticarcillin
Sachs et al. [27]Germany11n/aPatients (not specified)Convenience sampleLTTAminopenicillins
Warrington and Tse [28]Canada12n/aPatients (not specified)Convenience sampleLTTPenicillin

BAT: basophil activation test; CAP: commercially available kit to penicilloyl G and penicilloyl V; ECL: electrochemiluminescence; ELISA: enzyme-linked immunosorbent assay; ELISpot: enzyme-linked immunospot assay; FACS: flow cytometric analysis; HIPA: heparin-induced platelet activation; IgG: immunoglobulin G; IFN-γ: interferon gamma; LPA: lymphocyte proliferation assay; LTT: lymphocyte transformation test; RAST: radioallergosorbent test.