From the Research
Serum sickness is characterized by elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, indicating a systemic inflammatory response, and management involves discontinuation of the offending agent, supportive care, and potentially corticosteroids or antihistamines, as supported by studies such as 1. The clinical manifestations of serum sickness include fever, rash, arthralgia, lymphadenopathy, and sometimes proteinuria, occurring 7-14 days after exposure to a foreign protein or drug.
- Common triggers include certain antibiotics, monoclonal antibodies, antithymocyte globulin, and antivenoms.
- Laboratory values associated with serum sickness may show elevated ESR and CRP levels, as well as other markers of inflammation.
- Management primarily involves discontinuation of the offending agent and supportive care, with the following treatments:
- Antihistamines like diphenhydramine (25-50mg every 6 hours) for mild cases with pruritus.
- Corticosteroids such as prednisone (0.5-1mg/kg/day) for 5-7 days with a gradual taper for moderate to severe cases.
- NSAIDs like ibuprofen (400-600mg every 6-8 hours) to control joint pain and inflammation.
- In severe cases with significant organ involvement, hospitalization for monitoring and intravenous methylprednisolone (1-2mg/kg/day) may be necessary, as indicated by studies such as 2, 3, 4, 5. The condition results from immune complex formation between antibodies and the foreign protein, which deposit in tissues and activate complement, causing inflammation, and prevention involves avoiding re-exposure to the triggering agent and documenting the reaction in the patient's medical record as an allergy, as supported by the most recent study 1.