Immunologic studies in subjects with a serum sickness-like illness after immunization with human diploid cell rabies vaccine.
Ten patients developing a serum sickness-like hypersensitivity reaction to human diploid cell rabies vaccine were studied and compared with control subjects matched for previous vaccination history and level of rabies virus-specific IgG response to immunization. The clinical reaction consisted of delayed onset, generalized urticaria, and angioedema, with some arthralgias. Skin biopsy specimens demonstrated a leukocytoclastic vasculitis. Individuals reacting to the vaccine possessed IgE antibodies to human diploid cell rabies vaccine, to mock vaccine lacking viral antigen, and to fetal calf serum (FCS), a vaccine trace contaminant. Increased levels of IgG antibodies to FCS, mock vaccine, and beta-propiolactone-modified FCS, and human serum albumin were also found. Such humoral responses to vaccine components other than rabies virus might be responsible for the hypersensitivity reactions developing after rabies vaccination.
D000914:Antibodies, Viral / Q000032:analysis; D000936:Antigen-Antibody Complex / Q000032:analysis; D005260:Female; D006801:Humans; D007117:Immunization, Secondary; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D011819:Rabies Vaccines / Q000008:administration & dosage* / Q000276:immunology; D012713:Serum Sickness / Q000209:etiology / Q000276:immunology*; D012882:Skin Tests
D000914:Antibodies, Viral; D000936:Antigen-Antibody Complex; D007074:Immunoglobulin G; D011819:Rabies Vaccines