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serum_sickness

serum sickness

introduction

  • it is mediated by immune complexes (IgG/IgM)
  • Ab-Ag complexes in circulation in ratio 1-2:1 may cause deposition onto cell membranes activating complement
  • this causes local inflammation including urticaria with joint effusions
  • symptoms can take as long as fourteen days after exposure to appear
  • the term serum sickness–like reaction (SSLR) is occasionally used to refer to similar illnesses that arise from the introduction of certain non-protein substances

aetiology

  • cefaclor cephalosporins is a common cause in children
  • large doses of parenteral non-human protein administration is also a common cause
    • eg. polyvalent snake bite antivenoms
  • other medications

clinical features

  • rashes
  • pruritus
  • joint pain (arthralgia) +/- effusions
  • fever
  • lymphadenopathy
  • malaise
  • may cause:
    • hypotension and even shock
    • splenomegaly
    • glomerulonephritis and proteinuria

Rx

  • cease trigger
  • if severe, consider corticosteroids
  • most will settle within 4-5 days of ceasing trigger
serum_sickness.txt · Last modified: 2012/01/04 05:16 by 127.0.0.1

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