Serum sickness is a reaction that is similar to an allergy. The immune system reacts to medications that contain injected proteins used to treat immune conditions. Or it can react to antiserum, the liquid part of blood that contains
Causes, incidence, and risk factors
Plasma is the clear fluid portion of blood. It does not contain blood cells. However, it does contain many proteins, including antibodies, which are formed as part of the immune response to protect against infection.
Antiserum is produced from the plasma of a person or animal that has immunity against an infection or poisonous substance. Antiserum may be used to protect a person who has been exposed to a germ he or she has not been vaccinated again.
For example, you may receive a certain type of antiserum injection if you have been exposed to
During serum sickness, the immune system falsely identifies a protein in antiserum as a potentially harmful substance (
Certain medications (such as penicillin, cefaclor, and sulfa) can cause a similar reaction. Unlike other
Injected proteins such as antithymocyte globulin (used to treat organ transplant rejection) and rituximab (used to treat immune disorders and cancers) can cause serum sickness reactions.
Blood products may also cause serum sickness.
- General ill feeling
- Joint pain
- Swollen lymph nodes
Note: Symptoms usually do not develop until 7 – 21 days after the first dose of antiserum or exposure to the medication. However, some people may develop symptoms in 1 – 3 days if they have already been exposed to the substance.
Signs and tests
The lymph nodes may be enlarged and tender to the touch. The urine may contain blood or protein. Blood tests may show immune complexes or signs of blood vessel inflammation.
Corticosteroid creams or ointments or other soothing skin medications may relieve discomfort from itching and a rash.
Antihistamines may shorten the length of the illness and help ease a rash and itching.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may relieve joint pain. However, NSAIDs should be used carefully because of the risk for kidney damage. Corticosteroids taken by mouth (such as prednisone) may be prescribed for severe cases.
The medicine that caused the problem should be stopped. Avoid using that medication or antiserum in the future.
The symptoms usually go away within a few days.
If you use the drug or antiserum that caused serum sickness again in the future, your risk of having another similar reaction is high.
Anaphylactic shock, an immediate, life-threatening reaction
- Inflammation of the blood vessels
- Swelling of the face, arms, and legs (
Calling your health care provider
Call your health care provider if you have received medication or antiserum in the last 4 weeks and you have symptoms of serum sickness.
There is no known way to prevent the development of serum sickness.
People who have experienced serum sickness, anaphylactic shock, or drug allergy should avoid future use of the antiserum or drug.