Mai Nguyen
Mercer University COPHS
Doctor of Pharmacy Candidate 2012
June 9, 2011
Preceptor: Dr. Ali Rahimi

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
Introduction of
antigen
Body’s
immune
system
responds by
synthesizing
antibodies
after 4-10 days
Antibody
reacts with
antigen,
forming
soluble
complexes that
may diffuse
into vascular
walls and may
initiate
activation of
complement
Complement
-containing
immune
complexes
generate
influx of
leukocytes
into vessel
walls
Proteolytic
enzymes that
can mediate
tissue
damage are
released
Immune
complex
deposition +
inflammatory
response are
responsible
for vasculitic
lesions seen
in SS

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

Fever

Rash

Muscle aches


Hives
Swollen lymph
nodes

Difficulty breathing

Edema


Itching
Joint pain

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

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.
COMPLICATIONS

Vasculitis

Neuropathy

Anaphylaxis

Shock

Death
PROGNOSIS

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.
1.
Chen SM. (2010). Serum Sickness in
Emergency Medicine. Medscape. Retrieved
from http://emedicine.medscape.com/
article/756444-overview
2.
Henochowicz, SI. (2011). Serum Sickness.
PubMed Health. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmedhealt
h/PMH0001823/