TI - A prospective clinical and immunologic analysis of patients with serum sic kness.

SB - N Engl J Med 1984 Nov;311(22):1407-13 TA - N Engl J Med IP - 22 PG - 1407-13 DP - 1984 FAU - Lawley T J TJ FAU - Bielory L L FAU - Gascon P P FAU - Yancey K B KB FAU - Young N S NS FAU - Frank M M MM AU - Lawley T AU - Bielory L AU - Gascon P AU - Yancey K AU - Young N AU - Frank M AB - We prospectively evaluated the clinical and immunologic features of serum sickness in 12 patients with bone-marrow failure treated for 10 days with intravenous infusions of horse antithymocyte globulin. Eleven of the 12 patients had signs and symptoms of serum sickness 8 to 13 days after beginning therapy with antithymocyte globul in. Eleven patients (including 10 of 11 with signs and symptoms of serum sickness) acquired circulating immune complexes, wit h peak levels occurring at 10 to 12 days. Serum C4 and C3 levels fell precipitously, with nadirs on the 10th day. Plasma l evels of C3a anaphylatoxin were elevated in the four patients in whom it was measured. Eight of the 11 patients with signs a nd symptoms of serum sickness had a characteristic serpiginous erythematous and purpuric eruption on the hands and feet at the junc tion of palmar and plantar skin. Direct immunofluorescence of skin lesions revealed immune deposits (IgM, IgE, IgA, or C3) in the blood ves sels of three of five patients. This study documents the immunopathology of serum sickness in human beings and describes a cutaneous marker for the disease. IS - 0028-4793 LA - eng PT - Type:Journal Article PMID - 6387492 0 0 0 9007-36-7 DA - 1984 12 20 DCOM - 1984 12 20 LR - 2005 11 17 PL - UNITED STATES UOF - N Engl J Med 1984 Nov;311(22):1407-13 6387492