CHANGES IN INTRAVASCULAR COMPLEMENT AND ANTI-TREPONEMAL ANTIBODY TITERS PRECEDING JARISCH-HERXHEIMER REACTION IN SECONDARY SYPHILIS

  • 1 January 1976
    • journal article
    • research article
    • Vol. 24  (3) , 483-491
Abstract
Six patients with secondary syphilis and control subject were observed over a period of up to 8 h following the administration of penicillin or erythromycin. Serial clinical observations were made and blood samples obtained for complement (C) and serological analysis. The patients showed Jarisch-Herxheimer reactions (JHR) of varying intensity which were preceded by, and paralled in degree, certain changes in C and syphilitic antibody titers. Falls in total hemolytic C, in C4 [the 4th C component], C3, C6 and C7, and a marked drop in C1INH [C1 inhibitor] were observed. There was no change in total GBG [glycine-rich .beta.-glycoprotein]/GGG [activated Factor B] or evidence of conversion of GBG to GGG. Associated falls occurred in the titers of the QFTA [quantitative fluorescent treponemal antibody test] and the QTPHA [quantitative Treponema pallidum hemagglutination agglutination test] antibodies, but not of the QVDRL [quatitative Veneral Disease Research Laboratories test] or QTPI [quatitative T. pallidum immobilization test] antibodies. C3 conversion was found in the 2 patients that suffered severe reactions. Immune complexes were not detected. C activation apparently occurred in the extravascular body compartment. The significance of these changes in relation to other plasma enzyme systems and to the development of the full clinical picture of the JHR is discussed.