Arthus reaction: Difference between revisions
No edit summary |
Brian Blank (talk | contribs) No edit summary |
||
| Line 54: | Line 54: | ||
==See also== | ==See also== | ||
* [[Serum sickness]] | * [[Serum sickness]] | ||
{{SIB}} | {{SIB}} | ||
Revision as of 15:28, 29 May 2009
| Arthus reaction | |
| ICD-10 | T78.4 |
|---|---|
| ICD-9 | 995.21 |
| DiseasesDB | 33220 |
| MeSH | D001183 |
|
WikiDoc Resources for Arthus reaction |
|
Articles |
|---|
|
Most recent articles on Arthus reaction Most cited articles on Arthus reaction |
|
Media |
|
Powerpoint slides on Arthus reaction |
|
Evidence Based Medicine |
|
Clinical Trials |
|
Ongoing Trials on Arthus reaction at Clinical Trials.gov Trial results on Arthus reaction Clinical Trials on Arthus reaction at Google
|
|
Guidelines / Policies / Govt |
|
US National Guidelines Clearinghouse on Arthus reaction NICE Guidance on Arthus reaction
|
|
Books |
|
News |
|
Commentary |
|
Definitions |
|
Patient Resources / Community |
|
Patient resources on Arthus reaction Discussion groups on Arthus reaction Patient Handouts on Arthus reaction Directions to Hospitals Treating Arthus reaction Risk calculators and risk factors for Arthus reaction
|
|
Healthcare Provider Resources |
|
Causes & Risk Factors for Arthus reaction |
|
Continuing Medical Education (CME) |
|
International |
|
|
|
Business |
|
Experimental / Informatics |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Overview
In immunology, the Arthus reaction is a type of local type III hypersensitivity reaction. Type III hypersensitivity reactions are immune complex mediated, and involve the deposition of an antigen/antibody complex mainly in the vascular walls, serosa (pleura, pericardium, synovium), and glomeruli.
The Arthus reaction was discovered by Arthus in 1903.[1] Arthus repeatedly injected horse serum subcutaneously into rabbits. After four injections, he found that there was edema and that the serum was absorbed slowly. Further injections eventually led to gangrene.
The Arthus reaction involves the in situ formation of antigen/antibody complexes after the intradermal injection of an antigen. If the animal/patient was previously sensitized (has circulating antibody), an Arthus reaction occurs. This manifests as local vasculitis due to deposition of immune complexes in dermal blood vessels. Activation of complement and recruitment of PMNs ensue resulting in an inflammatory response.
Arthus reactions have been infrequently reported after vaccination against diphtheria and tetanus. To quote from the CDC:[2]
Arthus reactions (type III hypersensitivity reactions) are rarely reported after vaccination and can occur after tetanus toxoid–containing or diphtheria toxoid–containing vaccines. An Arthus reaction is a local vasculitis associated with deposition of immune complexes and activation of complement. Immune complexes form in the setting of high local concentration of vaccine antigens and high circulating antibody concentration. Arthus reactions are characterized by severe pain, swelling, induration, edema, hemorrhage, and occasionally by necrosis. These symptoms and signs usually occur 4–12 hours after vaccination.....ACIP has recommended that persons who experienced an Arthus reaction after a dose of tetanus toxoid–containing vaccine should not receive Td more frequently than every 10 years, even for tetanus prophylaxis as part of wound management.
References
- ↑ Injections répétées de serum du cheval chez le lapin, Comptes rendus des séances de la Société de biologie et de ses filiales, Paris, 55 (1903), 817–820.
- ↑ Preventing Tetanus, Diphtheria, and Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines, K. R. Broder et al., MMWR Recommendations and Reports, March 24, 2006 / 55(RR03), 1–34, page 18.