1. Serum sickness دکتر افشین شیرکانی
فوق تخصص آسم و آلرژی و بیماری های نقص ایمنی
عضو آکادمی آسم و آلرژی و ایمونولوژی آمریکا
استادیار دانشگاه

2. ETIOLOGY III—Immune complex reactions
1–3 weeks after drug exposure (Cefaclor) Antigen-antibody/aggregates
Blood vessels,liver, spleen,kidney, lung
Complement, anaphylatoxin,
Hypersensitivity pneumonitis

3. EPIDEMIOLOGY Common inciting agents include : blood products
foreign proteins: antithymocyte globulin and antivenoms
Medications: penicillin, sulfonamides, minocycline, cefaclor, hydantoins, and thiazides

4. CLINICAL MANIFESTATIONS
Urticaria,Petechiae/Purpura(dorsal and palmar or plantar aspects of the hands and feet)/fever
The symptoms of serum sickness typically occur 7 to 21 days after the administration of drugs, foreign proteins, or infections
Symptom onset may be more rapid (within 1 to 4 days) in previously sensitized individuals
polyarticular arthralgias, lymphadenopathy Carditis, glomerulonephritis, Guillain-Barresyndrome ,encephalomyelitis,and peripheral neuritis are rare complications

5. LABORATORY AND IMAGING STUDIES
Elevated ESR
Circulating immune complexes
Depressed complement (C3 and C4)
Skin biopsy( deposits of IgM, IgA, IgE, or C3)
Hematuria or proteinuria

6. TREATMENT AND PREVENTION
self-limited and resolves within 1 to 2 weeks
Antihistamines to relieve pruritus
NSAID drugs are given for fever and joint pain
prednisone (1 to 2 mg/kg orally daily)
Allergy skin testing does not predict the serum
sickness development
The primary means of prevention is to avoid exposure to the implicated cause