Anticonvulsant-induced XXXX : monitoring the immunologic response.

@entity1 @entity137 @entity6715 @entity310 @entity4619 @entity4105 @entity379 @entity1199
BACKGROUND: Toxic @entity6715 is a severe reaction with skin involvement induced by different drugs and other agents. The mechanisms implicated in the induction of the reaction are poorly understood. OBJECTIVE: Our purpose was to study the involvement of T lymphocytes and other immunocompetent cells in the peripheral blood, blister fluid, and affected skin of 3 @entity1 who had a severe reaction after receiving anticonvulsant medication. METHODS: Quantification of T lymphocytes expressing the skin-homing receptor (cutaneous lymphocyte-associated antigen   @entity4619 ) in peripheral blood, skin, and skin blister fluid and assessment of other adhesion molecules, activation markers, and inflammatory interleukins by flow cytometry, immunohistochemistry, and reverse transcription-PCR. RESULTS: An increase in CD3(+) @entity4619 (+) cells paralleling the severity of the disease was observed in both peripheral blood and skin, tending to normalize as soon as @entity1 's conditions improved. @entity4105 was detected in endothelial vessels in parallel with @entity4619 expression on lymphocytes. An overexpression of @entity310 , @entity379 , and @entity1199 was also observed in PBMCs. The expression of the different markers changed over the course of the disease. CONCLUSIONS: These data show an increase in activated T cells expressing the skin-homing receptor in both tissue and peripheral blood accompanying clinical symptoms, with a recruitment of macrophages and an overexpression of cytokines. All these results suggest an important role for T cells in the production of @entity137 .
