- Arthus reaction
Name = Arthus reaction
DiseasesDB = 33220
ICD10 = ICD10|T|78|4|t|66
ICD9 = ICD9|995.21
MeshID = D001183
immunology, the Arthus reaction is a type of local type III hypersensitivity reaction. Type III hypersensitivityreactions are immune complex-mediated, and involve the deposition of antigen/ antibodycomplexes mainly in the vascular walls, serosa(pleura, pericardium, synovium), and glomeruli.
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
serum subcutaneously into
rabbits. After four injections,he found that there was edemaand 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
vasculitisdue 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
vaccinationagainst diphtheriaand tetanus. 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.
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Arthus reaction — Ar·thus reaction är thəs , ȧr tues n a reaction that follows injection of an antigen into an animal in which hypersensitivity has been previously established and that involves infiltrations, edema, sterile abscesses, and in severe cases gangrene … Medical dictionary
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Arthus reaction (phenomenon) — Ar·thus reaction (phenomenon) (ahr tūsґ) [Nicolas Maurice Arthus, French physiologist, 1862â€“1945] see under reaction … Medical dictionary
reverse passive Arthus reaction — the reaction produced when precipitating antibody is inoculated into a skin site in an experimental animal, followed in 30 minutes to 2 hours by inoculation of the homologous antigen, either intravenously or intracutaneously at the same site.… … Medical dictionary
passive cutaneous Arthus reaction — a variation of the Arthus reaction in which a nonimmune host is inoculated with large quantities of precipitating antibody intravenously, followed by local cutaneous inoculation of antigen … Medical dictionary
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Arthus-type reaction — any pathologic process involving the same mechanism as the Arthus reaction, i.e., deposition of immune complexes and complement activation, as in immune complex disease … Medical dictionary