Abstract:
Objective The changes of lymphocyte subsets and liver dysfunction in patients with dermatitis medicamentosa-like of trichloroethylene were compared before and after treatments,to provide the clues for exploring the pathogenesis.
Methods The lymphocyte subsets and liver dysfunction of 14 patients diagnosed as medicamentosa-like of trichloroethylene,including 9 cases of exfoliative dermatitis and 5 cases of erythema multiforme,were measured before hospitalization and 2-3 months after treatment (when the clinical use of glucocorticoid was stopped).
Results The liver dysfunction was found at the beginning and the patients recovered after treatment. The percentages of CD3
+, CD8
+T lymphocyte cells were higher than the reference values (
t=2.283 -6.841,
P < 0.01),while the percentages of CD4
+ (CD3
+CD4
+) T lymphocyte cell,NK (CD3
-CD16+56
+) lymphocyte cell,B (CD3
-CD19
+) lymphocyte cell and CD4
+/CD8
+ ratio were lower than the reference values both before and after treatments (
t=-14.49——2.310,
P < 0.01). The percentages of CD8
+T lymphocyte and B lymphocyte cells of patients with exfoliative dermatitis were lower after treatment (
t=2.814,2.877,
P < 0.05).When lymphocyte subsets were compared among patients with erythema multiforme between before and after treatments,no statistically significant difference was noted. The numerical values of immunoglobulin M (IgM),immunoglobulin A (IgA) were lower after treatment (
t=2.256,2.293,
P < 0.05), while the numerical value of immunoglobulin G (IgG) had no statistically significant difference between before and after treatments (
t=1.783,
P>0.05). It was found that the GGT level at the beginning positive linear correlated with percentages of mature CD3
+,CD8
+ T lymphocyte cells (
r=0.496,0.470,
P < 0.05),while negative linear correlations were found between cholinesterase,albumin and mature CD3
+,CD8
+T lymphocytes cell (
r=-0.567,-0.475,-0.501,-0.516,
P < 0.05). Negative linear correlation was found between cholinesterase and lymphocytes cell after treatment (
r=-0.608,
P < 0.05).
Conclusion Immune dysfunction may exist among the patients with dermatitis medicamentosa-like of trichloroethylene in a long time. DMLT may result from the joint action of cellular immunity and humoral immunity. The proliferation of CD8
+T lymphocyte cells may involve the damaged mechanism of liver and skin.