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Arthus Reaction
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Arthus Reaction

Local Arthus Reaction
  • Produces localized vasculitis and tissue necrosis; rarely, it is associated with tetanus or diphtheria-containing vaccines.
  • It can be produced by re-injecting antigens too soon after initial exposure:
— The antigens form immune complexes with circulating IgG antibodies. — Then, the immune complexes activate complement and recruit inflammatory cells, including neutrophils and mast cells. — Inflammatory cell degranulation releases cytokines, enzymes, and other molecules that produce local inflammation at the injection site, which is marked by pain, swelling, and redness that typically subsides after a few days.
  • Type III hypersensitivity reactions are mediated by IgG (or IgM) antibody-antigen complexes; recall that these responses occur 1-3 hours after antigen exposure.
  • Normally, antibody-antigen complexes, aka, immune complexes, are removed by phagocytes of the spleen and lymph nodes.
  • However, persistent complexes can concentrate and cause tissue damage via complement and immune cell activation.
  • This most commonly occurs where blood or plasma is filtered through fenestrated capillaries; for example, in the synovial joints and renal glomeruli.

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