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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 an antigen/antibody complex mainly in the vascular walls, serosa (pleura, pericardium, synovium), and glomeruli.
The Arthus reaction was discovered by Arthus in 1903.^[1]
Arthus repeatedly injected horse
serum subcutaneously into rabbits. After four injections,
he found that there was edema and that the serum was absorbed slowly. Further injections eventually led to gangrene.
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 due to deposition of immune complexes in dermal blood vessels. Activation of complement and recruitment of PMNs ensue resulting in an inflammatory response.
Arthus reactions have been infrequently reported after vaccination against
diphtheria and tetanus. To quote from the CDC:^[2]

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.

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References

See also

References

1. 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), 817–820.
2. 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), 1–34, page 18.

See also

★ Serum sickness