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Anders Bengtson, MD; Mats Heideman, MD, PhD

Arch Surg. 1988;123(5):645-649.

Abstract
• Complement activation and anaphylatoxin formation were studied in 27 septic patients. The patients were treated with antibiotics and high-dose corticosteroids. Blood samples were drawn on admission and every week thereafter. Plasma levels of complement components C1INH, C3, C4, and C5 were low before the start of treatment but were above normal one week later in both successfully and unsuccessfully treated patients. In contrast, plasma levels of anaphylatoxins C3a/C3a_desArg and C5a/C5a_desArg were elevated on admission. After successful treatment, plasma levels of C3a/C3a_desArg and C5a/C5a_desArg returned to normal within one week. Nine patients had ongoing sepsis one week after the start of treatment and a persistent rise in anaphylatoxin concentration. They developed multisystem organ failure with respiratory, hepatic, and renal insufficiency. In vitro studies of Escherichia coli incubation in fresh serum indicated a dose-related formation of C3a/C3a_desArg and C5a/C5a_desArg. High concentrations of methylprednisolone inhibited the anaphylatoxin formation in vitro.

(Arch Surg 1988;123:645-649)

Author Affiliations
From the Departments of Anesthesiology and Intensive Care (Dr Bengtson) and Surgery I (Dr Heideman), Sahlgren's Hospital, University of Gothenburg, Gothenburg, Sweden.

Footnotes
Accepted for publication Feb 9, 1987.

Reprints not available.

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