Serum sickness after treatment with rabbit antithymocyte globulin in kidney transplant recipients with previous rabbit exposure

Am J Kidney Dis. 2010 Jan;55(1):141-3. doi: 10.1053/j.ajkd.2009.06.017. Epub 2009 Jul 23.


Serum sickness after rabbit antithymocyte globulin administration has a reported incidence of 7% to 27% in kidney transplant recipients. We describe 4 patients with previous exposure to rabbits who developed serum sickness after primary rabbit antithymocyte globulin induction. All patients presented with jaw pain. Three of 4 patients treated with plasmapheresis and steroids had prompt recovery, and 1 patient treated with steroids had slower recovery. We performed a telephone interview of 214 patients who contemporaneously underwent transplantation between November 2006 and July 2008 regarding rabbit exposure. More than half the patients had some type of previous rabbit exposure. There was a suggestion that patients with serum sickness were exposed more frequently to rabbits than those without. Jaw pain appears to be a hallmark symptom, and treatment with plasmapheresis and steroids relieves symptoms more rapidly than steroids alone.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Animals
  • Antilymphocyte Serum / adverse effects*
  • Antilymphocyte Serum / therapeutic use
  • Female
  • Graft Rejection / drug therapy*
  • Humans
  • Hypersensitivity, Delayed / complications
  • Hypersensitivity, Delayed / immunology*
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Rabbits
  • Serum Sickness / chemically induced*
  • Serum Sickness / immunology
  • Young Adult


  • Antilymphocyte Serum
  • Immunosuppressive Agents