- Arthus reaction
Infobox_Disease
Name = Arthus reaction
Caption =
DiseasesDB = 33220
ICD10 = ICD10|T|78|4|t|66
ICD9 = ICD9|995.21
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj =
eMedicineTopic =
MeshID = D001183
Inimmunology , the Arthus reaction is a type of localtype III hypersensitivity reaction . Type IIIhypersensitivity reactions areimmune complex -mediated, and involve the deposition ofantigen /antibody complexes mainly in the vascular walls,serosa (pleura, pericardium, synovium), andglomeruli .History
The Arthus reaction was discovered by Arthus in 1903. [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.] Arthus repeatedly injected
horse
serum subcutaneously intorabbit s. After four injections,he found that there wasedema and that the serum was absorbed slowly. Further injections eventually led togangrene .Process
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 againstdiphtheria andtetanus . To quote from the CDC: [ [http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5503a1.htm 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.]Arthus reactions (type III hypersensitivity reactions) arerarely reported after vaccination and can occur after tetanustoxoid–containing or diphtheria toxoid–containing vaccines. An Arthusreaction is a local vasculitis associated with deposition ofimmune complexes and activation of complement. Immunecomplexes form in the setting of high local concentration ofvaccine antigens and high circulating antibody concentration. Arthus reactions are characterized bysevere pain, swelling, induration, edema, hemorrhage, andoccasionally by necrosis. These symptoms and signs usuallyoccur 4–12 hours after vaccination.....ACIP has recommended thatpersons who experienced an Arthus reaction after a dose oftetanus toxoid–containing vaccine should not receive Td morefrequently than every 10 years, even for tetanus prophylaxis aspart of wound management.
References
ee also
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Serum sickness
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