Immunology of a serum sickness/vasculitis reaction secondary to streptokinase used for acute myocardial infarction.
We have studied six patients who received streptokinase for acute myocardial infarction (MI). One of these patients experienced a serum sickness/vasculitis reaction nine days after receiving the drug. Immunologic investigation of serum obtained from these individuals demonstrated that IgE and IgG anti-streptokinase antibody concentrations (measured by radioimmunoassay) were significantly elevated, both pre and post (IgE antibody, 36-fold increase) drug exposure, in the individual having the serum sickness/vasculitis reaction. Two of five of the remaining MI patients receiving the drug had post-exposure elevation of IgE anti-streptokinase antibody, but no patient had the immunologic profile seen in the individual with vasculitis. One should be aware that the serum sickness/vasculitis reaction can occur late after administration of streptokinase when the acute MI patient is recuperating.
Davidson
J R
JR
Department of Medicine, University of Wisconsin Hospital and Clinics, Madison 53792.
Bush
R K
RK
Grogan
E W
EW
Boh
L A
LA
Graziano
F M
FM
D000328:Adult; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy*; D012713:Serum Sickness / Q000209:etiology* / Q000276:immunology; D013300:Streptokinase / Q000009:adverse effects*; D014657:Vasculitis / Q000209:etiology* / Q000276:immunology
D007074:Immunoglobulin G; D007073:Immunoglobulin E; D013300:Streptokinase