The Kveim Reaction

Abstract

In 1941, Kveim, working in Danbolt’s department of dermatology is Oslo, reported that the intradermal injection of a heated suspension of tissue particles prepared from a sarcoid lymph-node caused a nodule to develop within nine days to four weeks in 12 out of 13 patients with sarcoidosis; that these nodules might increase in size for several weeks and persist for several months, and on biopsy showed histological changes resembling those of sarcoidosis; and that no reactions occurred in control subjects, including some with lupus vulgaris. Williams and Nickerson in 1935 briefly reported that they had prepared a suspension from a sarcoid skin lesion, and used it in the hope of obtaining a reaction in patients with sarcoidosis analogous to the Frei test in lymphogranuloma inguinale; and that in four patients thought to be suffering from sarcoidosis, a papule appeared in 24–36 hours and persisted for about a week, while in four control subjects there was no reaction. The clinical account of their four patients is very brief, but it seems arguable that two of them may have been suffering from regional ileitis. Harrell (1940) prepared suspensions from three sarcoid lymph-nodes; one gave ‘questionably positive’ reactions (presumably papules of the sort described by Williams and Nickerson) in three sarcoidosis patients, and the other two gave no reaction in four.