Serum sickness is a hypersensitivity reaction that occurs following the injection of foreign substances, proteins, or serum. Symptoms can include allergic reactions such as rashes, itching, difficulty breathing, and in severe cases, anaphylactic shock and death.
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| Caution is advised when using serum (Image: SK&ĐS) |
Animal-derived antivenom serums (primarily sourced from horses, such as tetanus and rabies antiserum) can cause serum sickness in 5-16% of patients.
Today, due to efforts to filter out allergens from horse serum and replace it with human serum, cases of serum sickness have decreased. However, the increased use of new biotechnology products like monoclonal antibodies for disease prevention may lead to a resurgence of serum sickness and similar reactions.
Symptoms of the disease can occur within 6-21 days after the introduction of foreign substances (medications or serum, proteins) into the body. The onset may be quicker, within 1-4 days, if the patient has previously used the same type of medication. Typically, patients over 15 years old exhibit more severe symptoms due to a higher dose of medication or antivenom introduced into the body.
Specific symptoms include fever, joint pain, swollen lymph nodes, and skin lesions; pain, itching, and redness at the injection site; muscle pain, chest pain, and difficulty breathing. Skin manifestations are usually the most pronounced and occur in over 95% of cases; common signs include rashes, hives, itching, swelling, pus formation, redness, and lesions all over the body, including the palms and soles of the hands and feet.
If the patient does not continue using the offending medication or serum, symptoms may improve after 1-2 weeks. If the condition goes undetected and the patient continues to use the allergens, it can lead to serious health consequences such as vasculitis, neuropathy, glomerulonephritis, and even anaphylactic shock and death.
In addition to typical serums, experts note that common pharmaceuticals can also cause similar reactions to serum sickness. In the United States, hundreds of cases emerge annually where patients experience serum sickness-like reactions after using antibiotics such as amoxicillin, cefaclor, cephalexin, bactrim, cotrim, septra, and sulfatrim…
The following biologically derived medical products theoretically and in practice can cause serum sickness: botulinum antitoxin, diphtheria antitoxin, gas gangrene antitoxin, anti-rejection serums for organ transplants, snake venom antivenom, and spider venom antivenom; allergen solutions for allergy testing and desensitization; blood products, hormones, venom, bacteria, and vaccines.
To treat serum sickness, patients may be given antihistamines, antipyretics, and analgesics…
Avoiding medications and serums is the best preventive measure against the disease. However, in reality, this is often unfeasible, as it is impossible to predict which patients will react to which medication, serum, or vaccine.
Skin reaction tests for patients with hypersensitivity symptoms before administering serum are generally unreliable for detecting those at risk for serum sickness.
In practice, when serum administration is necessary, it is advisable to establish intravenous access in both arms: one for serum infusion and the other for the timely management of potential reactions.
