Serum sickness

Last updated: October 21, 2022

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Serum sickness is a type III hypersensitivity reaction that usually develops as a complication of antitoxin or antivenom administration, but can also occur after antibiotic administration and hepatitis B infection. Symptoms typically occur 1–3 weeks after exposure to the offending agent and include fever, rash, and arthralgia. It is diagnosed clinically and treatment consists primarily of removing the offending agent.

Serum sickness is a classic example of a type III hypersensitivity reaction, which usually develops as a complication of antitoxin or antivenom administration.

Exposure to an antigen (e.g., antivenom, drug) → formation of antibodies deposition of antibody-antigen complexes in tissue → activation of the complement cascade → tissue damage and systemic inflammation

Symptoms appear 1–3 weeks following initial exposure (because antibodies take several days to form) and typically resolve within a few weeks after discontinuation of the offending agent.

See also “Hypersensitivity reactions.”

Serum sickness-like reaction

The differential diagnoses listed here are not exhaustive.

Prognosis is excellent once the offending drug is stopped or the causative infection has resolved.

  1. Solensky R, Khan DA et al. Drug Allergy: An Updated Practice Parameter. Ann Allergy Asthma Immunol. 2010; 105 (4): p.259-273.e78. doi: 10.1016/j.anai.2010.08.002 . | Open in Read by QxMD

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