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Author (up) Crone, N.E.; Reder, A.T. url  openurl
  Title Severe tetanus in immunized patients with high anti-tetanus titers Type Journal Article
  Year 1992 Publication Neurology Abbreviated Journal Neurology  
  Volume 42 Issue 4 Pages 761-764  
  Keywords Adult; Antibodies, Bacterial/*analysis; Clostridium tetani/isolation & purification; Female; Humans; *Immunization; Male; Middle Aged; Tetanus/*diagnosis/immunology/prevention & control  
  Abstract Severe (grade III) tetanus occurred in three immunized patients who had high serum levels of anti-tetanus antibody. The disease was fatal in one patient. One patient had been hyperimmunized to produce commercial tetanus immune globulin. Two patients had received immunizations 1 year before presentation. Anti-tetanus antibody titers on admission were 25 IU/ml to 0.15 IU/ml by hemagglutination and ELISA assays; greater than 0.01 IU/ml is considered protective. Even though one patient had seemingly adequate anti-tetanus titers by in vitro measurement (0.20 IU), in vivo mouse protection bioassays showed a titer less than 0.01 IU/ml, implying that there may have been a hole in her immune repertoire to tetanus neurotoxin but not to toxoid. This is the first report of grade III tetanus with protective levels of antibody in the United States. The diagnosis of tetanus, nevertheless, should not be discarded solely on the basis of seemingly protective anti-tetanus titers.  
  Address Department of Neurology, University of Chicago, IL 60637  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0028-3878 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:1565228 Approved no  
  Call Number DP @ pierredeterre2007 @ Serial 497  
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