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Serum sickness-like reaction in Infant/Neonate
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Serum sickness-like reaction in Infant/Neonate

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Contributors: Romi Bloom MD, Susan Burgin MD, Craig N. Burkhart MD, Dean Morrell MD
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Synopsis

Serum sickness-like reaction (SSLR) is a drug reaction that manifests with fevers, an urticarial or exanthematous rash, arthralgias, myalgias, and occasionally lymphadenopathy. As opposed to true serum sickness, it is not secondary to heterologous or chimeric therapeutic proteins and it usually lacks immune complex formation characteristic of serum sickness. The theorized pathogenesis for SSLR includes aberrant inflammation secondary to abnormal metabolism of medication byproducts. Most reactions occur within 1-3 weeks after drug initiation.

Eosinophilia may be present, but unlike true serum sickness, immune complexes, hypocomplementemia, and vasculitis are not found. Most reactions are mild and self-limited and resolve within several days to weeks after drug withdrawal.

Antibiotics, particularly cefaclor, penicillins, and sulfonamides, nonsteroidal anti-inflammatory drugs (NSAIDs), allopurinol, propranolol, and carbamazepine are among the most frequent offenders.

Codes

ICD10CM:
T80.69XA – Other serum reaction due to other serum, initial encounter

SNOMEDCT:
402658008 – Serum sickness type vasculitis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 08/07/2018
Last Updated: 12/14/2018
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Serum sickness-like reaction in Infant/Neonate
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Serum sickness-like reaction : Fever, Erythema, Primarily truncal, Symmetric extremities, Widespread, Arthralgia, Pruritus, Annular configuration
Clinical image of Serum sickness-like reaction
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