Circulating Immune Complexes, Complement Activation Kinetics and Serum Sickness following Treatment with Heterologous Anti‐snake Venom Globulin

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Abstract
Consecutive strum and plasms samples, from a patient receiving 100 ml polyvalent horse anti‐venom globulin after a rattlesnake bite, were analysed for circulating immune complexes (IC) and activation of complement factors. IC were determined by two independent methods, a complement consumption assay and a C1q‐binding assay. Rapidly rising levels of complement‐fixing circulating IC were detected as early as 4‐5 days after the serum treatment and distinct IC‐activity was recorded in both assays on day 8 when clinical symptoms of serum sickness were observed. The IC remained in circulation for at least 5 weeks. Signs of intravascular C‐activation in the form of low C3, C4 and C5 values was noted on day 1 after treatment. Factor B was demonstrable 3–4 days after the snake bite and this factor and C3c attained a peak around day 8, just before maximal suppression of native C3 and C4, 14 days after the globulin treatment C3c and B were declining rapidly while C3 and C4 approached normal values first 36 days after treatment. An increase in heterophilic antibodies to sheep erythrocytes was observed after treatment with anti‐venom globulin.