American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which condition is a common side effect of Anti-thymocyte globulin (ATG)?

1. Hypercalcemia

2. Cytokine release syndrome

3. Acute nephritis

4. Pneumothorax

The correct answer is: Cytokine release syndrome

Anti-thymocyte globulin (ATG) is used primarily as an immunosuppressive agent, particularly in the context of organ transplantation and certain autoimmune disorders. A common side effect associated with its administration is cytokine release syndrome. This syndrome occurs due to the activation of T-lymphocytes and the subsequent release of various pro-inflammatory cytokines into the bloodstream. When ATG is administered, it can lead to a rapid increase in cytokine levels, which may result in symptoms such as fever, chills, fatigue, and hypotension. Recognizing cytokine release syndrome is crucial for managing patients receiving ATG therapy, as it can present similarly to acute allergic reactions and may require supportive measures including the use of corticosteroids. Other conditions listed, while they may be associated with other treatments or drugs, are not typical side effects of ATG. For instance, hypercalcemia is generally not related to ATG administration, and acute nephritis is more associated with other immunosuppressive therapies or specific infections. Pneumothorax can occur due to various reasons but is not considered a direct complication of ATG therapy. Understanding cytokine release syndrome as a side effect of ATG highlights the importance of monitoring patients for such manifestations during treatment