Immune complex vasculitis

Andrews, A.G. et al., Immune complex vasculitis with secondary ulcerative dermatitis in aged C57BL/6NNia mice, Vet. Pathol., 31, 293, 1994. 

Type 3, immune complex vasculitis (serum sickness, Arthus reaction). Drug-antibody complexes precipitate on vascular walls, complement is activated, and an inflammatory reaction is triggered. Attracted neutrophils, in a futile attempt to phagocytose the complexes, liberate lysosomal enzymes that damage the vascular walls (inflammation, vasculitis). Symptoms may include fever, exanthema swelling of lymph nodes, arthritis, nephritis, and neuropathy. 

Cell therapy consists of the parenteral or enteral administration of cells or parts of cell obtained from animal organs and/or tissues from cattle, sheep, pigs, or rabbits. Two different types of cell preparations are in use fresh cells, which are administered in fresh form, and dried cells or so-called sicca cells, which are prepared for later use. The most prevailing risks of cell therapy are local and generalized allergic reactions (fever, nausea, vomiting, urticaria, and anaphylactic shock). Other untoward consequences include fatal and non-fatal encephalomyelitis, polyneuritis, Landry-Guillain-Barre sjmdrome, fatal serum sickness, perivenous leukoencephalitis, and immune-complex vasculitis. 

Although leucocytoclastic immune-complex vasculitis induced by levamisole is well known, this specific presentation with involvement of the ears has not been described before. 

The relationship between amphetamine abuse, the presence of hepatitis B antigenemia and immune complex vasculitis remains unclear [172-174]. While similar lesions have been described in non-drug abus-... 

Wolff HH, Madejewski M, Scherer R, Braun-Falco O (1978) Immunoelectromicroscope examination of early lesions in histamine induced immune complex vasculitis in man. Br J Dermatol 99 13... 

Mulligan, M.S., Moncada, S. and Ward, P.A. (1992). Protective eflfect of inhibitors of nitric oxide synthase in immune complex-induced vasculitis. Br. J. Pharmacol. 107, 1159-1162. 

Type III Drugs may cause serum sickness, which involves immune complexes containing IgG and is a multisystem complement-dependent vasculitis that may also result in urticaria. 

G20. Gupta, R. C., and Kohler, P. F., Identification of HBsAg determinants in immune complexes from hepatitis B virus-associated vasculitis. J. Immunol. 132, 1223-1228 (1984). 

Christian, C. L., Isolation and characterization of circulating immune complexes in patients with hepatitis B systemic vasculitis. Clin. Immunol. Immunopathol. 21,364-374 (1981). 

M12. McDuffie, F. C., Sams, W. M., Maldonado, J. E., Andreini, P. H., Conn, D. L., and Samayoa, E. A., Hypocomplementemia with cutaneous vasculitis and arthritis. Possible immune complex syndrome. Mayo Clin. Proc. 48, 340-348 (1973). 

R2. Rapoport, R. J., Kozin, F., Macket, S. E., and Jordon, R. E., Cutaneous vascular immunofluorescence in rheumatoid arthritis Correlation with circulating immune complexes and vasculitis. Am. J. Med. 68, 325-331 (1980). 

Groger M, Fischer GF, Wolff K, Petzelbauer P. Immune complexes from vasculitis patients bind to endothelial Fc receptors independent of the allelic polymorphism of FcgammaRIIa. J Invest Dermatol 1999 113(l) 56-60. 

III Immune complex mediated, complement dependent Serum sickness, drug fever, vasculitis... 

A review of furosemide-induced skin reactions included a description of a unique case of an 88-year-old man who developed an eruption that clinically and histologically simulated Sweet s syndrome (acute febrile neutrophilic vasculitis) after 6 weeks (15). Atypical features and rapid resolution suggested a drug eruption rather than true Sweet s syndrome. However, a similar mechanism may have been implicated a hypersensitivity reaction involving immune complexes. 

Vasculitis has been rarely described after streptokinase or anistreplase (64-67), but not after urokinase or alteplase. It is characterized by lymphocyte infiltration and deposition of immune complexes, fibrin, and complement in the skin microvasculature. 

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