[Autopsy findings in a case of fatal dextran reaction (author's transl)]

A report of fatal dextran reaction is presented. A patient who had had a stable circulatory status developed massive systemic venous congestion and irreversible cardiac arrest after receiving an infusion of approximately 50 ml of dextran solution. Autopsy showed total occlusion of the pulmonary circulation as a result of precipitation of the dextran-blood mixture. Similar occlusion was demonstrated in capillaries in the kidneys, spleen and cardiac musculature. Death occurred during acute, right-sided heart failure. Pathogenetically a type III allergic reaction with precipitation of antigen antibody complexes in the presence of excess antibody is suspected. In cases such as this one, with no history of prior exposure to dextran, sensitization may have occured with a substance sharing antigenic properties with dextran.