Serum Sickness Publications (2355)


Serum Sickness Publications

Innate Immun
Innate Immun 2017 Jan 21;23(1):97-108. Epub 2016 Nov 21.
2 University of Florida, Range Cattle Research and Education Center, Ona, FL, USA.
J. Cutan. Pathol.
J Cutan Pathol 2016 Nov 10. Epub 2016 Nov 10.
Department of Dermatology, University of Minnesota, Minneapolis, MN, USA.

The diagnosis of serum sickness-like reaction (SSLR) is typically based on clinical findings. Histopathologic examination is often deferred, as these eruptions commonly present in young children, and often to primary care providers. A PubMed literature search revealed only five existing cases of SSLR which describe cutaneous histopathologic features. Read More

We report two cases of SSLR, one each to bupropion and cefazolin. Skin biopsy findings in both cases showed a neutrophil-predominant urticarial pattern resembling neutrophilic urticaria or neutrophilic urticarial dermatosis. We also provide a summary of the histopathologic findings that can help support a diagnosis of SSLR.

Am. J. Physiol. Regul. Integr. Comp. Physiol.
Am J Physiol Regul Integr Comp Physiol 2016 Nov 7;311(5):R940-R947. Epub 2016 Sep 7.
Centre de Recherche du CHU de Québec, Pavillon St François d'Assise, Département de Pédiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada;

The impact of cerebral erythropoietin (Epo) in the regulation of the hypercapnic ventilatory response (HcVR) is controversial. While we reported that cerebral Epo does not affect the central chemosensitivity in C57Bl6 mice receiving an intracisternal injection of sEpoR (the endogenous antagonist of Epo), a recent study in transgenic mice with constitutive high levels of human Epo in brain and circulation (Tg6) and in brain only (Tg21), showed that Epo blunts the HcVR, maybe by interacting with central and peripheral chemoreceptors. High Epo serum levels in Tg6 mice lead to excessive erythrocytosis (hematocrit ~80-90%), the main symptom of chronic mountain sickness (CMS). Read More

These latter results support the hypothesis that reduced central chemosensitivity accounts for the hypoventilation observed in CMS patients. To solve this intriguing divergence, we reevaluate HcVR in Tg6 and Tg21 mouse lines, by assessing the metabolic rate [O consumption (V̇) and CO production (V̇)], a key factor modulating ventilation, the effect of which was not considered in the previous study. Our results showed that the decreased HcVR observed in Tg6 mice (~70% reduction; < 0.01) was due to a significant decrease in the metabolism (~40%; < 0.0001) rather than Epo's effect on CO chemosensitivity. Additional analysis in Tg21 mice did not reveal differences of HcVR or metabolism. We concluded that cerebral Epo does not modulate the central chemosensitivity system, and that a metabolic effect upon CO inhalation is responsible for decreased HcVR observed in Tg6 animals. As CMS patients also show decreased HcVR, our findings might help to better understand respiratory disorders at high altitude.

Nephrol. Dial. Transplant.
Nephrol Dial Transplant 2016 Oct 25. Epub 2016 Oct 25.
Department of Nephrology, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany.

Antithymocyte globulins (ATGs) are part of the immunosuppression arsenal currently used by clinicians to prevent or treat acute rejection in solid organ transplantation. ATG is a mixture of non-specific anti-lymphocyte immunoglobulins targeting not only T cell subsets but also several other immune and non-immune cells, rendering its precise immunoglobulin composition difficult to appreciate or to compare from one preparation to another. Furthermore, several mechanisms of action have been described. Read More

Taken together, this probably explains the efficacy and the side effects associated with this drug. Recent data suggest a long-term negative impact on allograft and patient outcomes, pointing out the need to better characterize the potential toxicity and the benefit-risk balance associated to this immunosuppressive therapy within large clinical trials.

J Pediatric Infect Dis Soc
J Pediatric Infect Dis Soc 2016 Oct 28. Epub 2016 Oct 28.
Virginia H. Rogers Professor of Pediatric Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611.

From 1908 to 1929, Clemens von Pirquet was one of the world's most acclaimed pediatricians. Von Pirquet (1874-1929) trained at Vienna's Universitäts Kinderklinic under Theodor Escherich, the first Pediatric Infectious Diseases physician [ 1], and became the first Professor and Chair of Pediatrics at Johns Hopkins in 1909. He then succeeded his mentor Escherich as Professor and Chair of Pediatrics in Vienna, the most prestigious European pediatric position, when Escherich died unexpectedly in 1911. Read More

He held that position in Vienna until his shocking double suicide at age 54 with his wife in 1929. Von Pirquet's pioneering contributions from 1903 to 1910 related to host reactions to foreign substances, providing much of the foundation for modern "Immunology". In 1905, he and his student Bela Schick described and named "serum sickness" in children administered animal antiserum. He recognized that animal antiserum resulted in both protection against an infection but also sensitization (sometimes with serious or fatal consequences), ie, that immune responses caused some diseases. In 1906, he proposed the term "allergy" for the altered reactivity induced by what he termed an "allergen", a foreign substance. He recognized that sensitization to an allergen leads to accelerated responses on subsequent allergen administration, analogous to differences between primary and subsequent smallpox vaccine responses. In 1908, von Pirquet presented his invention, the "tuberculin skin test", recognizing its ability to identify individuals with previous tuberculosis infection, then the most prevalent infectious disease. This led to the new understanding that many or most tuberculosis-infected individuals are asymptomatic but at risk for future active disease, introducing the concept of "latent tuberculosis". Von Pirquet was a consummate pediatrician-scientist, translating scientific discoveries directly into improved care of children, and he also pioneered study of the social, nutritional, and public health aspects of pediatrics, especially during and after World War I.

J Clin Pharm Ther
J Clin Pharm Ther 2016 Dec 24;41(6):736-738. Epub 2016 Sep 24.
Le Bonheur Children's Hospital, Memphis, TN, USA.

Metronidazole (MTZ) is a commonly prescribed antibiotic and is generally well tolerated. To our knowledge, there has been only one case report linking MTZ with serum sickness-like reaction (SSLR).
We report a probable case of SSLR following the administration of MTZ in a paediatric patient. Read More

Serum sickness-like reaction may be associated with MTZ therapy, and this type of adverse drug reaction may be underreported in the literature. A prior case report and evaluation with the Naranjo algorithm indicating a 'probable' adverse drug reaction provide evidence to support this conclusion.

Transbound Emerg Dis
Transbound Emerg Dis 2016 Dec 19;63(6):e270-e277. Epub 2015 Feb 19.
VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain.

African horse sickness (AHS) is a viral disease that causes high morbidity and mortality rates in susceptible Equidae and therefore significant economic losses. More rapid, sensitive and specific assays are required by diagnostic laboratories to support effective surveillance programmes. A novel microsphere-based immunoassay (Luminex assay) in which beads are coated with recombinant AHS virus (AHSV) structural protein 7 (VP7) has been developed for serological detection of antibodies against VP7 of any AHSV serotype. Read More

The performance of this assay was compared with that of a commercial enzyme-linked immunosorbent assay (ELISA) and commercial lateral flow assay (LFA) on a large panel of serum samples from uninfected horses (n = 92), from a reference library of all AHSV serotypes (n = 9), on samples from horses experimentally infected with AHSV (n = 114), and on samples from West African horses suspected of having AHS (n = 85). The Luminex assay gave the same negative results as ELISA when used to test the samples from uninfected horses. Both assays detected antibodies to all nine AHSV serotypes. In contrast, the Luminex assay detected a higher rate of anti-VP7 positivity in the West African field samples than did ELISA or LFA. The Luminex assay detected anti-VP7 positivity in experimentally infected horses at 7 days post-infection, compared to 13 days for ELISA. This novel immunoassay provides a platform for developing multiplex assays, in which the presence of antibodies against multiple ASHV antigens can be detected simultaneously. This would be useful for serotyping or for differentiating infected from vaccinated animals.

Adv Med
Adv Med 2016 21;2016:7579069. Epub 2016 Sep 21.
Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Internal Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.