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Serum Sickness

Zaiba Jetpuri, MBA, FAAFP, DO and Nida Zahra, MD, FAAFP Reviewed 05/2023
 


BASICS

DESCRIPTION

  • An immune reaction that results in antibody-antigen complexes (typically a protein and IgG/IgM) and triggers a systemic response

  • Often in response to vaccinations and medications

  • Clini...

DIAGNOSIS

HISTORY

  • History of exposure to medication or serum in preceding 1 to 3 weeks

  • Absence of chronic constitutional symptoms

  • Common symptoms include:

    • Fever (>38.5° C)

    • Edema (especially facial)

    • Regio...

TREATMENT

GENERAL MEASURES

  • Discontinue the offending agent; improvement usually seen in 48–72 hours.

  • Complete resolution of rash may take days to weeks; time to improvement depends on antigen half-life.

  • ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Bed rest during acute illness if severe arthralgia/myalgia

  • No indication for skin testing for β-lactam antibiotics because severe non–IgE-mediated reactions are dr...

REFERENCES

1
Alvares  ML, Warrier  I. Pneumococcal vaccine after IVIG treatment causing serum sickness. Paper presented at: 2010 Annual Meeting of the American College of Allerg...

ADDITIONAL READING

  • Hempel  C, Martin  C. Getting under the skin of adverse drug reactions. Orthopedics.  2012; 35(10): 872– 876.

  • Karm...

CODES

ICD10

  • T80.6 Other serum reactions

  • T80.61 Other serum reaction due to administration of blood and blood products

  • T80.61xA Other serum reaction due to administration of blood and blood products, init...

CLINICAL PEARLS

  • Consider serum sickness inpatients with rash, myalgias, and malaise and recent exposure to a foreign antigen.

  • Cutaneous drug reactions are among the most commonly reported adverse drug ...

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