Drug Reactions

Allergies to penicillin and sulfonamides

■ Infectious Diseases Poststreptococcal glomerulonephritis Meningitis

Hepatitis

Mononucleosis

Malaria

Trypanosomiasis

Symptoms of serum sickness

Free Ab

Symptoms of serum sickness

Free Ab

Serum Sickness

6 8 10 12 14 16 Time after BSA injection, days

FIGURE 16-16

6 8 10 12 14 16 Time after BSA injection, days

FIGURE 16-16

Correlation between formation of immune complexes and development of symptoms of serum sickness. A large dose of antigen (BSA) was injected into a rabbit at day 0. As antibody formed, it complexed with the antigen and was deposited in the kidneys, joints, and capillaries. The symptoms of serum sickness (light blue area) corresponded to the peak in immune-complex formation. As the immune complexes were cleared, free circulating antibody (dashed black curve) was detected and the symptoms of serum sickness subsided. [Based on F. G. Germuth, Jr., 1953, J. Exp. Med. 97:257.]

Complexes of antibody with various bacterial, viral, and parasitic antigens have been shown to induce a variety of type III hypersensitive reactions, including skin rashes, arthritic symptoms, and glomerulonephritis. Poststreptococcal glomeru-lonephritis, for example, develops when circulating complexes of antibody and streptococcal antigens are deposited in the kidney and damage the glomeruli. A number of autoimmune diseases stem from circulating complexes of antibody with self-proteins, with glycoproteins, or even with DNA. In systemic lupus erythematosus, complexes of DNA and anti-DNA antibodies accumulate in synovial membranes, causing arthritic symptoms, or accumulate on the basement membrane of the kidney, causing progressive kidney damage.

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