Department of Dental Anesthesiology, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
Department of Dental Anesthesiology and Orofacial Pain Management, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
Oral Maxillofac Surg. 2024 Nov 5;29(1):5. doi: 10.1007/s10006-024-01295-2.
The Drug Lymphocyte Stimulation Test (DLST), recognized for its safety as an allergy diagnostic modality, has been acknowledged for its utility in diagnosing drug-induced pathological conditions. However, reports elucidating DLST outcomes concerning local anesthetics are notably scarce.
An exhaustive analysis was conducted on the DLST results pertaining to local anesthetics derived from 571 patients presenting with suspected allergies to these specific agents.
Remarkably, Stimulation Index (SI) > 1.8 was discerned in 11.4% and 7.8% of patients exhibiting hives or swelling subsequent to the administration of local anesthetics, surpassing the incidence observed in those experiencing post-injection discomfort. Additionally, SI > 3.0 was observed in 3 cases with lidocaine, 3 cases with prilocaine, and 1 case with mepivacaine. The distribution of SI exhibited a non-normal pattern for all three tested local anesthetics. Noteworthy is the case of a singular patient registering an SI of 1.84, who also yielded a positive challenge test, conclusively confirming an allergy to lidocaine.
The DLST, holding promise as a potentially invaluable tool in identifying the causative factors behind adverse reactions to dental local anesthetics, lacks sufficient evidence to substantiate its efficacy definitively at present.
DLST, coupled with intradermal testing and challenge testing, may be elucidated in patients exhibiting indicators of suspected local anesthetic allergy.
药物淋巴细胞刺激试验（DLST）作为一种安全的过敏诊断方法已得到认可，它也被证实可用于诊断药物引起的病理状况。然而，关于局部麻醉剂的 DLST 结果的报告却非常罕见。
对 571 名疑似对这些特定药物过敏的患者的局部麻醉剂 DLST 结果进行了全面分析。
值得注意的是，在接受局部麻醉剂后出现荨麻疹或肿胀的患者中，刺激指数（SI）>1.8 的比例分别为 11.4%和 7.8%，超过了注射后不适的患者的发生率。此外，在 3 例利多卡因、3 例丙胺卡因和 1 例甲哌卡因中观察到 SI>3.0。所有三种测试的局部麻醉剂的 SI 分布均呈非正态模式。值得注意的是，有一例患者的 SI 为 1.84，他还进行了阳性挑战测试，最终证实对利多卡因过敏。
DLST 作为一种可能非常有价值的工具，可用于识别引起牙科局部麻醉剂不良反应的原因，但目前还没有足够的证据确定其疗效。
DLST 与皮内试验和挑战试验相结合，可用于表现出疑似局部麻醉剂过敏迹象的患者。
