[Investigation of Anti-Cancer Drugs Suspected as Causative Agents of Allergy by Drug-Induced Lymphocyte Stimulation Test and Subsequent Re-Administration].

Twenty-one patients underwent a drug-induced lymphocyte stimulation test(DLST)withanti -cancer drugs suspected as causative agents of allergy between January 1, 2013, and December 31, 2017, at Ichinomiya Municipal Hospital, and 7 (33.3%)and 14 patients were positive and negative, respectively. Moreover, only 2 out of 21 people had a low value in lymphocyte blast transformation test induced by phytohemagglutinin, and their immune ability was maintained. Two patients suspected of drug eruption were re-administered after a positive determination. Letrozole was re-administered in 1 patient, but exemestane was administered after the patient relapsed. The other patient received lenalidomide in combination with dose-reduction and prednisolone(PSL), and the patient did not relapse. Seven patients were re-administered after negative determination, and none of them relapsed. These results confirmed that re-administration was possible depending on the type of side effects even in DLST positive cases; however, it was necessary to take various precautions. Moreover, DLST results were an index for finding the cause, and it is important to consider other diagnostic methods carefully during re-administration.

Sustained high plasma mannose less sensitive to fluctuating blood glucose in glycogen storage disease type Ia children.

Plasma mannose is suggested to be largely generated from liver glycogen-oriented glucose-6-phosphate. This study examined plasma mannose in glycogen storage disease type Ia (GSD Ia) lacking conversion of glucose-6-phosphate to glucose in the liver. We initially examined fasting--and postprandial 2 h--plasma mannose and other blood carbohydrates and lipids for seven GSD Ia children receiving dietary interventions using cornstarch and six healthy age-matched children. Next, one-day successive intra-individual parameter changes were examined for six affected and two control children. Although there were no significant differences in fasting--and postprandial 2 h--glucose and insulin levels, the mannose level of the affected group was invariably much higher than that of the control group (p < 0.001): the fasting level of the affected group was about two-fold that of the control group; the postprandial-2 h level remained almost unchanged in the affected group, although it was one-half of the fasting level in the control group. Inter-individual analyses revealed that the GSD Ia group mannose level was significantly and positively correlated with lactate and triglycerides levels at both time points (p < 0.01). In each control, mannose levels fluctuated greatly, maintaining strong and significant negative correlations with glucose and insulin levels (p < 0.001). Correlations were lower or nonexistent in GSD Ia children. In individuals with high lactate and triglycerides levels, strikingly high mannose levels never changed against glucose and insulin fluctuations. Plasma mannose is less sensitive to blood glucose and insulin in GSD Ia children. Its basal level and the fluctuation pattern differ by their metabolic activity.