Immunological aspects of adverse reactions to althesin

Sequential plasma samples from 30 patients showing clinical signs of hypersensitivity to Althesin were investigated to determine if a specific immune response to the drug was present (as measured by classical complement pathway activation) or if a non-antibody-dependent alternative complement pathway activation was taking place. The patients were classified as those reacting on first exposure to Althesin and those who reacted adversely only on a second exposure. The alternative complement pathway, but not the classical pathway, was activated in five of the 13 first-time reactors, while in the remaining eight no complement activation was detected. In contrast, classical complement pathway activation was demonstrated in the blood samples of all 17 patients reacting on repeat exposure. Severe reactions occurred in nine of the 17 previously exposed patients compared with only one of the 13 reacting on first exposure to Althesin.