Serum sickness after treatment with rabbit antithymocyte globulin in kidney transplant recipients with previous rabbit exposure.
Serum sickness after rabbit antithymocyte globulin administration has a reported incidence of 7% to 27% in kidney transplant recipients. We describe 4 patients with previous exposure to rabbits who developed serum sickness after primary rabbit antithymocyte globulin induction. All patients presented with jaw pain. Three of 4 patients treated with plasmapheresis and steroids had prompt recovery, and 1 patient treated with steroids had slower recovery. We performed a telephone interview of 214 patients who contemporaneously underwent transplantation between November 2006 and July 2008 regarding rabbit exposure. More than half the patients had some type of previous rabbit exposure. There was a suggestion that patients with serum sickness were exposed more frequently to rabbits than those without. Jaw pain appears to be a hallmark symptom, and treatment with plasmapheresis and steroids relieves symptoms more rapidly than steroids alone.
Boothpur
Raghavender
R
Barnes-Jewish Hospital, St Louis, MO, USA.
Hardinger
Karen L
KL
Skelton
Rebecca M
RM
Lluka
Brunilda
B
Koch
Matthew J
MJ
Miller
Brent W
BW
Desai
Niraj M
NM
Brennan
Daniel C
DC
D000328:Adult; D000818:Animals; D000961:Antilymphocyte Serum / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000150:complications / Q000276:immunology*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D012713:Serum Sickness / Q000139:chemically induced* / Q000276:immunology; D055815:Young Adult
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents