Circulating immune complexes, complement activation kinetics and serum sickness following treatment with heterologous anti-snake venom globulin.
Consecutive serum and plasma samples, from a patient receiving 100 ml polyvalent horse anti-venom globulin after a rattlesnake bite, were analysed for circulating immune complexes (IC) and activation of complement factors. IC were determined by two independent methods, a complement consumption assay and a Clq-binding assay. Rapidly rising levels of complement-fixing circulating IC were detected as early as 4--5 days after the serum treatment and distinct IC-activity was recorded in both assays on day 8 when clinical symptoms of serum sickness were observed. The IC remained in circulation for at least 5 weeks. Signs of intravascular C-activation in the form of low C3, C4 and C5 values was noted on day 1 after treatment. Factor B was demonstrable 3--4 days after the snake bite and this factor and C3c attained a peak around day 8, just before maximal suppression of native C3 and C4. 14 days after the globulin treatment C3c and B were declining rapidly while C3 and C4 approached normal values first 36 days after treatment. An increase in heterophilic antibodies to sheep erythrocytes was observed after treatment with anti-venom globulin.
D000328:Adult; D000936:Antigen-Antibody Complex; D000997:Antivenins / Q000009:adverse effects* / Q000627:therapeutic use; D002850:Chromatography, Gel; D003176:Complement C3 / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D003182:Complement C5 / Q000032:analysis; D003165:Complement System Proteins / Q000032:analysis; D006801:Humans; D007118:Immunoassay; D007123:Immunoelectrophoresis, Two-Dimensional; D008297:Male; D012713:Serum Sickness / Q000209:etiology* / Q000276:immunology; D012909:Snake Bites / Q000276:immunology / Q000628:therapy*
D000936:Antigen-Antibody Complex; D000997:Antivenins; D003176:Complement C3; D003181:Complement C4; D003182:Complement C5; D003165:Complement System Proteins