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Table 1 Types of adverse reactions caused by antivenoms

From: Antivenom therapy: efficacy of premedication for the prevention of adverse reactions

Adverse reaction Type Cause Mechanism Main physiological effects
IgE-mediated anaphylactic Early Presence of patient IgE against any component of antivenom Basophil and mast cell degranulation by IgE.
Release of histamine, prostaglandins, leukotrienes and other pharmacological mediators
Increased vascular permeability, vasodilatation, bronchial and visceral smooth-muscle contraction, anaphylactic shock
Non IgE-mediated anaphylactic Early Presence of aggregates, Fc fragments or heterophilic antibodies against blood cells in antivenom Complement activation by Ig aggregates and others.
Basophil and mast cell degranulation by complement.
Release of histamine, prostaglandins, leukotrienes and other pharmacological mediators
Increased vascular permeability, vasodilatation, bronchial and visceral smooth-muscle contraction, rash, urticaria, pain
Pyrogenic Early Presence of endotoxins in antivenom Macrophage and other cell activation by endotoxins.
TNF-α, IL-1, IL-6 production
Fever
Serum sickness Late Humoral immune response to antivenom Complement activation by immunocomplex.
Basophil and mast cell degranulation by complement.
Release of histamine, prostaglandins, leukotrienes and other pharmacological mediators
Rash, glomerulonephritis
  1. Ig immunoglobulin, IgE immunoglobulin E, TNF-α tumor necrosis factor alpha, IL-1 interleukin 1, IL-6 interleukin 6