Serum Sickness
Basics
Description
Description
- Type III hypersensitivity reaction
- When a foreign protein or drug (the antigen) is injected, the body's immune system responds by forming antibodies to the foreign material and subsequently forms complexes composed of the antigen, antibody, and complement
- These complexes then deposit in tissue, inciting an inflammatory response:
- C3a and C5a act as anaphylatoxins
- C5a is strongly chemotactic for neutrophils
- The neutrophils then infiltrate the vessel wall at the site of the immune complex deposition and release enzymes, such as collagenase and elastase, which damage vessel walls
- Typically, symptoms arise 6–21 d after the primary exposure to the antigen
- Symptoms can start 1–4 d after exposure if there has been an initial immunizing exposure
- Symptoms typically last 1–2 wk before spontaneously resolving
Etiology
Etiology
- Serum sickness:
- Vaccines containing foreign protein or serum such as pneumococcal vaccine or rabies
- Antivenom and tetanus inoculations made with horse or sheep protein
- Monoclonal antibodies
- Serum sickness–like reaction:
- Caused by nonprotein drugs, mostly antibiotics:
- Penicillins, amoxicillin
- Cephalosporins (i.e., Cefaclor)
- Sulfonamides (i.e., Bactrim)
- Thiazides
- Gold
- Thiouracils
- Hydantoins
- Phenylbutazone
- Aspirin
- Streptomycin
- Caused by nonprotein drugs, mostly antibiotics:
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Citation
Schaider, Jeffrey J., et al., editors. "Serum Sickness." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307429/all/Serum_Sickness.
Serum Sickness. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307429/all/Serum_Sickness. Accessed December 1, 2024.
Serum Sickness. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307429/all/Serum_Sickness
Serum Sickness [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 01]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307429/all/Serum_Sickness.
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