Serum Sickness

1
Serum Sickness

• Mai Nguyen
• Mercer University COPHSDoctor of Pharmacy
  Candidate 2012
• June 9, 2011
• Preceptor Dr. Ali Rahimi

2
Overview

• 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

3
Pathophysiology
4
Pathophysiology
5
Causes

• 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

6
Symptoms

• Fever
• Muscle aches
• Hives
• Itching
• Joint pain
• Rash
• Swollen lymph nodes
• Difficulty breathing
• Edema

7
Signs and Tests

• 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

8
Treatment

• 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.

9
Complications and Prognosis

• Complications

• Prognosis

• Vasculitis
• Neuropathy
• Anaphylaxis
• Shock
• Death

• 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.

10
References

• Chen SM. (2010). Serum Sickness in Emergency
  Medicine. Medscape. Retrieved from
  http//emedicine.medscape.com/
• article/756444-overview
• Henochowicz, SI. (2011). Serum Sickness. PubMed
  Health. Retrieved from http//www.ncbi.nlm.nih.gov
  /pubmedhealth/PMH0001823/