Classical pathway activation during an adverse response to protamine sulphate.
A severe anaphylactoid reaction was observed following the i.v. administration of protamine sulphate in a 66-year-old male undergoing coronary artery catheterization. Serial measurements of complement factors (C3 and C4) and C3 split products (C3c and C3d) were performed by conventional electro-immunoassays and by double zone rocket immunoelectrophoresis. A parallel decrease in circulating C3 and C4 concentrations was seen for 1 h, reaching a nadir at 1.3 h. Markedly increased concentrations of C3c and C3d were observed in the first sample examined after exposure to the drug. C3c and C3d concentrations gradually declined to the normal range within 5.9 h and 21.8 h, respectively. These observations are discussed in relation to the mechanism of this adverse reaction.
D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced*; D003167:Complement Activation / Q000187:drug effects*; D003176:Complement C3 / Q000032:analysis; D015932:Complement C3c; D015933:Complement C3d; D003181:Complement C4 / Q000032:analysis; D003171:Complement Pathway, Classical / Q000187:drug effects*; D006801:Humans; D007122:Immunoelectrophoresis; D008297:Male; D011479:Protamines / Q000009:adverse effects*; D013997:Time Factors
D003176:Complement C3; D003181:Complement C4; D011479:Protamines; D015932:Complement C3c; D015933:Complement C3d