Serum sickness in Adult
Alerts and Notices
Synopsis
Serum sickness typically occurs 7-21 days after exposure to exogenous proteins or chemicals. Antigens induce antibody production resulting in circulating antigen-antibody complexes that deposit within postcapillary venules. Subsequent complement activation releases vasoactive amines and cytokines, leading to symptoms and signs that include urticaria (often first noticed at the site of injection), fever, myalgias, arthralgias, arthritis, and lymphadenopathy. The disease is usually self-limited and lasts less than one week. Renal, hepatic, pulmonary, gastrointestinal tract, and central nervous system involvement may rarely occur. Previously sensitized hosts can see an accelerated onset of symptoms occurring 1-3 days after exposure to the antigen.
Related topic: Serum sickness-like reaction
Codes
ICD10CM:T80.69XA – Other serum reaction due to other serum, initial encounter
SNOMEDCT:
72284000 – Serum sickness
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Systemic lupus erythematosus
- Serum sickness-like reaction (incited by nonprotein drugs)
- Rocky Mountain spotted fever
- Leukocytoclastic vasculitis
- Exanthematous drug eruption
- Hereditary angioedema
- Drug hypersensitivity syndrome (drug rash with eosinophilia and systemic symptoms [DRESS])
- Erythema multiforme
- Urticaria
- Infective endocarditis
- Cryoglobulinemia
- Mononucleosis
- Urticarial vasculitis
- Immunoglobulin A vasculitis (formerly Henoch-Schönlein purpura)
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.Subscription Required
References
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Last Reviewed:08/06/2018
Last Updated:12/13/2018
Last Updated:12/13/2018
Serum sickness in Adult