Cytokine release syndrome: Difference between revisions
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'''Cytokine | '''Cytokine Release syndrome''' is a common immediate complication occurring with the use of anti-[[T cell]] [[antibody]] infusions such as [[Anti-thymocyte globulin|ATG]], [[OKT3]] and [[TGN1412]]. Severe cases are known as [[cytokine storm | cytokine storms]]. | ||
The pathogenesis is that the [[antibody|antibodies]] bind to the [[T cell]] receptor, activating the T cells before they are destroyed. The [[cytokine]]s released by the activated T cells produce a type of [[systemic inflammatory response syndrome|systemic inflammatory response]] similar to that found in severe [[infection]] characterised by [[hypotension]], [[pyrexia]] and [[rigor (medicine)|rigors]]. The patient feels very unwell, as if in a high [[fever]] – indeed, the cytokine release syndrome ''is'' effectively a type of non-infective fever. | The pathogenesis is that the [[antibody|antibodies]] bind to the [[T cell]] receptor, activating the T cells before they are destroyed. The [[cytokine]]s released by the activated T cells produce a type of [[systemic inflammatory response syndrome|systemic inflammatory response]] similar to that found in severe [[infection]] characterised by [[hypotension]], [[pyrexia]] and [[rigor (medicine)|rigors]]. The patient feels very unwell, as if in a high [[fever]] – indeed, the cytokine release syndrome ''is'' effectively a type of non-infective fever. | ||
Latest revision as of 17:55, 6 February 2015
Cytokine Release syndrome is a common immediate complication occurring with the use of anti-T cell antibody infusions such as ATG, OKT3 and TGN1412. Severe cases are known as cytokine storms.
The pathogenesis is that the antibodies bind to the T cell receptor, activating the T cells before they are destroyed. The cytokines released by the activated T cells produce a type of systemic inflammatory response similar to that found in severe infection characterised by hypotension, pyrexia and rigors. The patient feels very unwell, as if in a high fever – indeed, the cytokine release syndrome is effectively a type of non-infective fever.
Deaths due to cytokine release syndrome with OKT3 have been reported, and it can cause life-threatening pulmonary oedema if the patient is fluid overloaded. However, if treated appropriately it is usually not dangerous, just extremely unpleasant for the patient.
The effect is greatly reduced by intravenous administration of an anti-histamine (such as chlorphenamine) and a corticosteroid (such as hydrocortisone) prior to starting the ATG/OKT3 infusion, with further doses of anti-histamine and steroid given during the infusion if necessary.
Causes
- Drugs
See also
- cytokine storm, life threatening massive release of cytokines