Serum sickness is a reaction to an antiserum derived from an animal source. It is a type of hypersensitivity, specifically immune complex (type 3) hypersensitivity. Serum sickness typically develops up to ten days after exposure to the antiserum, and symptoms are similar to an allergic reaction. However, it is different from anaphylaxis, since the symptoms are not instantaneous (onset is typically 2-4 weeks after exposure). A reaction is the following: In physics, a reaction (physics) is defined by Newtons third law: For every action there is an equal and opposite reaction. The idea that any given force has a pair or opposite force. ... Antiserum is blood serum containing antibodies. ... For other uses, see Animal (disambiguation). ... Hypersensitivity refers to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. ... Antiserum is blood serum containing antibodies. ... Pancreatitus can be caused by an Allergic Reaction to a food. ... Anaphylaxis is an acute systemic (multi-system) and severe Type I Hypersensitivity allergic reaction. ...

Causes

Serum sickness can be developed as a result of exposure to antibodies derived from animals. Drugs that cause serum sickness reaction pattern include antibiotics (especially penicillins and sulfonamides). These serums are generally administered in order to prevent or treat infection. The body produces antibodies, which combine with these proteins to form immune complexes. These complexes can cause more reactions, and cause the symptoms detailed below. Serum sickness can also be caused by several drugs, notably penicillin based medicines, including sulfa drugs or sulfonamides, such as Septra DS, Bactrim and the the group called fluoroquinolones, ie. Ciprofloxacin. When the antiserum is given, the human immune system can mistake the proteins present for harmful antigens. Virtually any antibiotic that has as its primary target stimulating the immune system can result in serum sickness. Foreign proteins such as streptokinase, those found in vaccines, and those used in monoclonal antibody therapy can be associated with a serum sickness syndrome with leukocytoclastic vasculitis (LCV), usually the result of failure to provide proper treatment (eg, overaggressive treatment of a patient with chronic but mild disease or undertreatment of a patient with severe systemic disease). Serum sickness-like illness can rarely manifest as the Guillain-Barre syndrome, one of its most serious complications. Wikipedia does not yet have an article with this exact name. ... For other uses, see Animal (disambiguation). ... Wikipedia does not yet have an article with this exact name. ... Immune Complex Diseases An immune complex is the combination of an epitope with an antibody directed against that epitope. ... It has been suggested that Blockbuster drug be merged into this article or section. ... Penicillin nucleus Penicillin (sometimes abbreviated PCN) refers to a group of β-lactam antibiotics used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms. ... Sulfonamides, also known as sulfa drugs, are synthetic antimicrobial agents derived from sulfonic acid. ... Sulfonamides, also known as sulfa drugs, are synthetic antimicrobial agents derived from sulfonic acid. ... Ciprofloxacin is the generic international name for the synthetic antibiotic manufactured and sold by Bayer Pharmaceutical under the brand names Cipro and Ciproxin (and other brand names in other markets, e. ... Antiserum is blood serum containing antibodies. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... This article does not cite any references or sources. ... Guillain-Barré syndrome (GBS), is an acquired immune-mediated inflammatory disorder of the peripheral nervous system (i. ...

Serum Sickness is a hypersensitivity reaction to the administration of foreign serum or serum proteins characterized by fever, urticaria, arthralgia, edema, and lymphadenopathy. It is caused by the formation of circulating antigen-antibody complexes that are deposited in tissues and trigger tissue injury mediated by complement and polymorphonuclear leukocytes. Serum sickness is classed with the Arthus reaction and other immune complex diseases as a type III hypersensitivity reaction (Gell and Coombs classification). Although serum sickness is now rare because of the replacement of most animal-derived antisera with human immune globulins, an identical illness (serum sickness–like reaction or syndrome) can be produced by hypersensitivity reactions to penicillin and other drugs. Serum sickness is a reaction to an antiserum derived from an animal source. ...

Serum sickness is a group of symptoms caused by a delayed immune response to certain medications or antiserum (passive immunization with antibodies from an animal or another person). Antibody-mediated immunity is active when the person synthesizes his own antibody; serum sickness usually occurs in passive immunity, not acquired immunity. Serum anti-GQ1b IgG antibody is associated with ataxia as well as ophthalmoplegia in Miller Fisher syndrome (MFS) and Guillain-Barre syndrome: MFS patients have circulating IgG antibodies. Ataxia may be due to its binding to a subset of primary sensory neurons. © 1999 John Wiley & Sons, Inc. Muscle Nerve 22: 1071-1074, 1999. In a medical sense, immunity is a state of having sufficient biological defenses to avoid infection, disease, or other unwanted biological invasion. ...

Serum sickness, allergy (hypersensitivity responses) such as IgG-mediated, or T cell-mediated (for instance, poison ivy), and anaphylaxis, are all manifestations of undesirable immune responses. T cell depression in serum sickness, marked by a drop in the absolute number of lymphocytes is most often associated with iatrogenic causes secondary to drugs, notably penicillin based medicines and sulfonamides such as Bactrim. It is also well documented that Cipro causes drug induced serum sickness.

Caution: Overstimulating the immune system has a causal relationship to rheumatoid arthritis, dermatomyositis, lupus erythematosus and many other immune mediated illnesses. Catastrophic over-stimulation of the immune system can trigger Guillain-Barré syndrome (GBS). Guillain-Barré syndrome (GBS) or acute inflammatory demyelinating polyradiculoneuropathy is an acute, autoimmune disease that affects the peripheral nervous system and is usually triggered by an acute infectious process. ...

Symptoms

Symptoms can take as long as fourteen days after exposure to appear, and may include:

• Rash; dermatitis (eg, exfoliative dermatitis), hives, itching or small areas of skin swelling
• Arthralgia, joint pain
• Malaise, or "feeling lousy"
• Nausea, vomiting, or diarrhea
• Headache, migraine/vascular
• Fever (may or may not be present)
• Lymph node swelling (lymphadenopathy)
• Shock (ie. anaphylactic shock)
• Hypotension, decreased blood pressure
• splenomegaly, enlarged spleen
• Macule lesions, ie. drug eruptions; blistering heralds a severe drug eruption.
• Anemia, ie. immune hemolytic anemia

Serum sickness may be characterized by malaise; flu-like symptoms such as nausea and vomiting, anorexia, headache, feeling dizzy, lethargy, chills, abdominal discomfort (with fecal incontinence), and other systemic syndromes suggestive of serum sickness. Serum sickness, in particular, is associated with tiredness, occasional fever, water retention, skin rash, fatigue (unusual tiredness) or weakness, and abnormal gait. The urine may contain blood or protein. Serum Sickness may also present with signs and symptoms similar to intestinal parasites. Joint pain may be reported in up to 50% of cases. A rash is a change in skin which affects its color, appearance or texture. ... Arthralgia is a term used to describe pain in the joints. ... Malaise is a feeling of general discomfort or uneasiness, an out of sorts feeling, often the first indication of an infection or other disease. ... For the Beck song, see Nausea (song). ... A headache (cephalalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... An analogue medical thermometer showing the temperature of 38. ... In mammals including humans, the lymphatic vessels (or lymphatics) are a network of thin tubes that branch, like blood vessels, into tissues throughout the body. ... Lymphadenopathy is a term meaning disease of the lymph nodes. ... Shock is a serious medical condition where the tissue perfusion is insufficient to meet the required supply of oxygen and nutrients. ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... Splenomegaly is an enlargement of the spleen, which usually lies in the left upper quadrant (LUQ) of the human abdomen. ... The macule is the simplest dermatological lesion. ... Anemia (AmE) or anæmia (BrE), from the Greek () meaning without blood, is a deficiency of red blood cells (RBCs) and/or hemoglobin. ...

Treatment

Symptoms will generally disappear on their own, although corticosteroids may be prescribed in the most severe forms. Antihistamine may also be used. In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... An antihistamine is a drug which serves to reduce or eliminate effects mediated by histamine, an endogenous chemical mediator released during allergic reactions, through action at the histamine receptor. ...

Prognosis

Most serum sickness reactions are mild, and disappear on their own after one or two weeks as long as the cause is removed. Sometimes, symptoms of pain and discomfort may continue for several weeks, even after all the observable reactions such as skin rash and protein in the urine have disappeared. In very rare cases, however, there can be severe reactions and permanent damage. In very rare but extreme cases, serum sickness can lead to shock, permanent kidney damage, and even death.

History

Primary serum sickness occurs 6-21 days after the administration of the inciting antigen. The onset may be more rapid with subsequent exposures to the same antigen, with symptoms occurring 1-4 days after exposure.

References

• eMedicine - Serum Sickness : Article by Hassan M Alissa, MD [[1]]; Neurologic complications.

• eMedicine - Drug Eruptions : Article by Jonathan E Blume, MD [[2]]; Serum sickness and serum sickness–like drug induced reactions.

• CliffsNotes:Antibody‐Mediated Immunity: [[3]]

• Medscape - [[4]] IgG Subclass Deficiency in Adults