[The enlarged diagnosis of the fatal penicillin accident. Immunehistologic demonstration of antigen-antibody complexes and of antibodies against the tubular basement membrane after administraiton of depot penicillin].
In a case of fatal penicillin allergy it proved possible at autopsy to demonstrate (by immunohistological examination of basal membranes of proximal renal tubuli) antigen-antibody complexes belonging to the penicillin (BPO) group and to an anti-penicilloyl antibody of the IgG type. In addition, complement C3 was detected. Antibodies against the basal membranes or renal tubuli were also demonstrated in material eluted from the kidney, although an inflammatory reaction ot the immunoligical changes had not yet been observed in light microscopy. It is undecided whether this discrepancy is due to the low dose of penicillin administered or the relatively short time lag between first injection and time of fatality. It is assumed that, pathogenetically, a reaction of the serum sickness type is probably involved. For etiological clarification the use of immunohistological methods in addition to serological procedures provides further indices for an antecedent sensitization to penicillin, because assay effectiveness does not decrease even after a lengthy postmortal time-lapse. On the other hand, tissues and serum for examination should be frozen at low temperatures immediately after autopsy.
D000936:Antigen-Antibody Complex; D001323:Autoantibodies / Q000032:analysis; D001485:Basement Membrane; D003176:Complement C3 / Q000032:analysis; D004342:Drug Hypersensitivity / Q000276:immunology*; D006801:Humans; D007687:Kidney Tubules, Proximal; D008297:Male; D008875:Middle Aged; D010406:Penicillins
D000936:Antigen-Antibody Complex; D001323:Autoantibodies; D003176:Complement C3; D010406:Penicillins
Zur erweiterten Diagnostik des tödlichen Pencillin-Zwischenfalles.