title: Anaphylactoid reaction to muromonab-CD3 in a pediatric renal transplant recipient.
abstract: 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.
authors.affiliation: Department of Surgery, University of Vermont College of Medicine, Burlington, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Berkowitz
authors.forename: C J
authors.initials: CJ
authors.lastname: Possidente
authors.forename: B R
authors.initials: BR
authors.lastname: McPherson
authors.forename: A
authors.initials: A
authors.lastname: Guillot
authors.forename: S V
authors.initials: SV
authors.lastname: Braun
authors.forename: J C
authors.initials: JC
authors.lastname: Reese
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D016853:Muromonab-CD3