A 33-year-old man received equine-derived antitoxin following a snakebite. Eight days later, he presents with fever (38.8°C), diffuse arthralgias, urticarial rash, and mild dyspnea. Vital signs show HR 102/min, BP 128/76 mmHg, RR 20/min, SpO2 98% on room air. Urinalysis reveals 2+ proteinuria. He denies previous antitoxin exposure. Which of the following best explains the pathophysiologic mechanism of this reaction?

  1. A)Preexisting antibodies against donor endothelial antigens
  2. B)Direct T cell cytotoxicity against skin keratinocytes
  3. C)IgE mediated mast cell degranulation
  4. D)Antibody dependent cellular cytotoxicity by natural killer cells
  5. E)Immune complex deposition with complement activationGABARITO

Explicação

This patient has serum sickness, a classic type III hypersensitivity reaction. Circulating antigen antibody complexes deposit in tissues, activate complement, and cause fever, arthralgias, rash, and glomerular injury days after exposure. Ver explicação completa e trilha adaptativa →

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