Claas F H
Department of Immunohaematology, Leiden Academic Hospital, The Netherlands.
Eur J Haematol Suppl. 1996;60:64-8. doi: 10.1111/j.1600-0609.1996.tb01648.x.
Drug-induced blood dyscrasias may be due to toxicity of the drug, inborn errors of metabolism or immunological reactions. In the latter case, drug-induced antibodies are directed to specific target cells, such as platelets (thrombocytopenia) or granulocytes (agranulocytosis). Some of these immune mechanisms are based on the physical interaction between drug, antibody and target cells. A particular drug may bind to the surface of the blood cell which, as a carrier of the drug, will be destroyed as part of the immune reaction to the drug (hapten mechanism). Other drugs will form immune complexes with drug-specific antibodies. These immune complexes will bind to certain blood cells and destroy them as innocent bystanders (immune complex mechanism). In vitro assays are described which enable the offending drug to be detected by mimicking these immune mechanisms using patient serum, platelets or granulocytes, and the suspected drug. The diagnostic value of these in vitro assays is discussed.
药物引起的血液系统疾病可能是由于药物毒性、先天性代谢缺陷或免疫反应所致。在后一种情况下，药物诱导产生的抗体作用于特定的靶细胞，如血小板（血小板减少症）或粒细胞（粒细胞缺乏症）。其中一些免疫机制基于药物、抗体和靶细胞之间的物理相互作用。特定药物可能会结合到血细胞表面，作为药物载体的血细胞会在针对该药物的免疫反应（半抗原机制）中被破坏。其他药物会与药物特异性抗体形成免疫复合物。这些免疫复合物会结合到某些血细胞上，并将它们作为无辜旁观者加以破坏（免疫复合物机制）。本文描述了一些体外检测方法，这些方法通过使用患者血清、血小板或粒细胞以及可疑药物来模拟这些免疫机制，从而检测出致病药物。文中还讨论了这些体外检测方法的诊断价值。
