Anaphylactoid reaction to muromonab-CD3 in a pediatric renal transplant recipient.
Muromonab-CD3 (OKT3), a murine IgG2a antibody directed against the T3 (CD3) complex on mature lymphocytes, triggers adverse immune reactions. Anaphylactic reactions have occurred in patients exposed to OKT3 and are mediated by anti-OKT3 IgE antibodies. The reactions are not antibody mediated and can occur within seconds of administration of a mast cell secretogogue. A renal transplant recipient became hypotensive and hypoxic immediately after receiving her first dose of OKT3 and required advanced life support. Serum antibody tests were negative for anti-OKT3 IgG, IgE, and antimouse protein antibodies. To our knowledge, this is the first published report of a patient with an anaphylactoid reaction to the initial infusion of OKT3.
Berkowitz
R J
RJ
Department of Surgery, University of Vermont College of Medicine, Burlington, USA.
Possidente
C J
CJ
McPherson
B R
BR
Guillot
A
A
Braun
S V
SV
Reese
J C
JC
D000293:Adolescent; D000707:Anaphylaxis / Q000139:chemically induced*; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007676:Kidney Failure, Chronic; D016030:Kidney Transplantation; D016853:Muromonab-CD3 / Q000009:adverse effects*; D011184:Postoperative Period
D007166:Immunosuppressive Agents; D016853:Muromonab-CD3