Plasmapheresis and RATG‐induced serum sickness

Patients with serum sickness after rejection treatment with RATG were randomly allocated in 2 groups. Group I (n = 8) was treated with analgesics and group II (n = 7) with plasmapheresis. In group I, serum sickness lasted for ± 10–14 days. Only a slight beneficial effect of analgesics was observed. Six of 8 patients from group I developed decreased renal function, which gradually improved thereafter. The maximal rise in serum creatinin was 226.1 ± 115.6 μmol/1. After the plasmapheresis, an immediate relief of fever, arthralgias and arthritis occurred in group II. Two days after starting plasmapheresis, serum sickness had completely disappeared. During serum sickness, 5 of the 7 patients showed an increased serum creatinin (maximal increase: 137.4 ± 108 μmol/l). After plasmapheresis, serum creatinin decreased in 2–3 d to base values. There were no adverse effects of plasmapheresis. In conclusion, plasmapheresis is a safe and very effective treatment of RATG‐induced serum sickness.