Anaphylactoid Reaction Following an Intradermal Test of Tetanus Antitoxin

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Abstract
The clinical course and the immunological response of a patient with an anaphylactoid reaction following an intradermal skin test with tetanus antitoxin have been described. Shock and hypotension occurred within a few minutes of the test dose. Subsequent urticaria and fever developed and continued for four days before complete clinical recovery. Therapy included epinephrine, steroids, and antihistamines. A relatively high horse serum reagin titer was present shortly after the anaphylactoid reaction. This subsequently rose to an extremely high level. The reagin is probably the important immunological mediator of this acute anaphylactoid reaction. A slightly elevated hemagglu-tinating antibody titer was also found shortly after the reaction. This antibody titer subsequently rose to levels seen with primary serum disease. The failure of symptoms of primary serum disease to develop may possibly be attributed to the steroid treatment of the acute reaction.