Serum Sickness
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Transcript Serum Sickness
Mai Nguyen
Mercer University COPHS
Doctor of Pharmacy Candidate 2012
June 9, 2011
Preceptor: Dr. Ali Rahimi
Serum sickness is a reaction similar to an
allergy.
Specifically, type III hypersensitivity reaction
to certain medications, injected proteins used
to treat immune conditions, or antiserum
▪ Antiserum: liquid part of blood that
contains antibodies that help protect against
infectious or poisonous substances
▪ Example: Tetanus vaccine
Introduction of
antigen
Body’s
immune
system
responds by
synthesizing
antibodies
after 4-10 days
Antibody
reacts with
antigen,
forming
soluble
complexes that
may diffuse
into vascular
walls and may
initiate
activation of
complement
Complement
-containing
immune
complexes
generate
influx of
leukocytes
into vessel
walls
Proteolytic
enzymes that
can mediate
tissue
damage are
released
Immune
complex
deposition +
inflammatory
response are
responsible
for vasculitic
lesions seen
in SS
Antiserum
Tetanus or rabies vaccination
Medications
PCN
Sulfa
▪ Unlike other drug allergies, which occur very soon after receiving the
medication again, SS develops 7-21 days after the first exposure to
medication
Injected proteins
Antithymocyte globulin (ATG) - treat organ transplant rejection
Rituximab – mAb treats immune disorders and cancers
Blood products
Fever
Rash
Muscle aches
Hives
Swollen lymph
nodes
Difficulty breathing
Edema
Itching
Joint pain
Lymph nodes may be enlarged and tender
to touch.
Urine may contain blood or protein.
Blood tests may show immune complexes
or signs of blood vessel inflammation
Elevated erythrocyte sedimentation rate
Leukocytosis
Corticosteroid creams or ointments – relieve
discomfort from itching and rash
Antihistamines – may shorten length of illness
and help ease rash and itching
NSAIDS – may relieve joint pain
Tylenol – helpful in relieving fever and muscle
pain
Medications causing problem should be stopped
and future use should be avoided.
COMPLICATIONS
Vasculitis
Neuropathy
Anaphylaxis
Shock
Death
PROGNOSIS
Most cases are mild and
resolve within a few days.
Symptoms may persist
for several weeks.
Fatalities are rare and
usually are due to
continued administration
of the antigen.
1.
Chen SM. (2010). Serum Sickness in
Emergency Medicine. Medscape. Retrieved
from http://emedicine.medscape.com/
article/756444-overview
2.
Henochowicz, SI. (2011). Serum Sickness.
PubMed Health. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmedhealt
h/PMH0001823/