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Editor,—I read with interest Maria and Victorino’s work (Gut 1997;41:534–40) on the diagnostic value of specific T cell reactivity to drugs in 95 cases of drug induced liver injury. They are to be congratulated on assembling the largest group of patients with suspected drug induced hepatotoxicity and attempting to assess causality using their lymphocyte test.
In their discussion, when referring to the clinical significance of the presence of prostaglandin producing suppressor cells in vitro, they state that, “patients in which this phenomenon was detected had a less severe disease, as assessed by aminotransferase concentrations and more rapid cure.” There is another potential clinical significance to the interpretation of their in vitro results and that is …