Arthus reaction 4406991 224850842 2008-07-10T18:22:00Z Arcadian 104523 nav {{Infobox_Disease | Name = Arthus reaction | Image = | Caption = | DiseasesDB = 33220 | ICD10 = {{ICD10|T|78|4|t|66}} | ICD9 = {{ICD9|995.21}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D001183 | }} In [[immunology]], the '''Arthus reaction''' is a type of local [[type III hypersensitivity reaction]]. Type III [[hypersensitivity]] reactions are [[immune complex]]-mediated, and involve the deposition of [[antigen]]/[[antibody]] complexes mainly in the [[blood vessel|vascular]] walls, [[serosa]] (pleura, pericardium, synovium), and [[glomeruli]]. ==History== The Arthus reaction was discovered by [[Nicolas Maurice Arthus|Arthus]] in [[1903]].<ref>Injections répétées de serum du cheval chez le lapin, ''Comptes rendus des séances de la Société de biologie et de ses filiales'', Paris, '''55''' (1903), 817&ndash;820.</ref> Arthus repeatedly injected [[horse]] [[blood plasma|serum]] subcutaneously into [[rabbit]]s. After four injections, he found that there was [[edema]] and that the serum was absorbed slowly. Further injections eventually led to [[gangrene]]. ==Process== The Arthus reaction involves the in situ formation of antigen/antibody complexes after the intradermal injection of an antigen. If the animal/patient was previously sensitized (has circulating antibody), an Arthus reaction occurs. This manifests as local [[Vasculitis|vasculitis]] due to deposition of immune complexes in dermal blood vessels. Activation of complement and recruitment of [[Granulocyte|PMNs]] ensue, resulting in an inflammatory response. Arthus reactions have been infrequently reported after [[vaccination]] against [[diphtheria]] and [[tetanus]]. To quote from the [[Centers for Disease Control and Prevention|CDC]]:<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5503a1.htm Preventing Tetanus, Diphtheria, and Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines], K. R. Broder et al., ''MMWR Recommendations and Reports'', March 24, 2006 / 55(RR03), 1&ndash;34, page 18.</ref> <blockquote> Arthus reactions (type III hypersensitivity reactions) are rarely reported after vaccination and can occur after tetanus toxoid–containing or diphtheria toxoid–containing vaccines. An Arthus reaction is a local vasculitis associated with deposition of immune complexes and activation of complement. Immune complexes form in the setting of high local concentration of vaccine antigens and high circulating antibody concentration. Arthus reactions are characterized by severe pain, swelling, induration, edema, hemorrhage, and occasionally by necrosis. These symptoms and signs usually occur 4–12 hours after vaccination.....ACIP has recommended that persons who experienced an Arthus reaction after a dose of tetanus toxoid–containing vaccine should not receive Td more frequently than every 10 years, even for tetanus prophylaxis as part of wound management. </blockquote> ==Arthus Reaction in Popular Culture== The notorious villain from the Warcraft series of computer games, Arthas Menethil, was reportedly named after this hypersensitivity reaction. ==References== <references /> ==See also== * [[Serum sickness]] {{Consequences of external causes}} {{Immune disorders}} [[Category:Immunology]] {{immunology-stub}} [[ja:アルサス反応]]