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June 29, 1946

FATAL ANAPHYLACTIC SHOCK: Occurrence in Identical Twins Following Second Injection of Diphtheria Toxoid and Pertussis Antigen

Author Affiliations

New York

From the Office of the Chief Medical Examiner, City of New York, and the Pathology Department of St. John's Long Island City Hospital.

JAMA. 1946;131(9):730-735. doi:10.1001/jama.1946.02870260014003

Deaths related to the injection of foreign protein in man are fortunately few. The exact number of such occurrences is difficult to estimate from the available literature. By 1942 Kojis1 was able to find 61 such deaths, and he added 4 more from the Willard Parker Hospital. The most complete and most recent study of necropsies was made by Vance and Strassmann,2 who added 7 autopsy studies from the Office of the Chief Medical Examiner to 19 taken from the literature. Park3 in 1932 recorded the mortality from serum anaphylaxis as 0.002 per cent. Kojis1 in 1942 found it to be just under 0.1 per cent in a series of 6,211 subjects treated for various infections. Rutstein and his associates,4 in their analysis of pneumonia cases treated with antipneumococcus horse serum, found the mortality to be 0.45 per cent. In only 1 or possibly 2

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