serum sickness


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serum sickness,

hypersensitive response that occurs after injection of a large amount of foreign protein. The condition is named for the serum taken from horses or other animals immunized against a particular disease, e.g., tetanus or diphtheria. Such serum, which contains antibodiesantibody,
protein produced by the immune system (see immunity) in response to the presence in the body of antigens: foreign proteins or polysaccharides such as bacteria, bacterial toxins, viruses, or other cells or proteins.
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 against the disease toxinstoxin,
poison produced by living organisms. Toxins are classified as either exotoxins or endotoxins. Exotoxins are a diverse group of soluble proteins released into the surrounding tissue by living bacterial cells. Exotoxins have specific reaction sites in the host; e.g.
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, was formerly widely used to temporarily immunize humans. However, the antibodies from the animal serum are also foreign proteins that can act as antigens when injected into humans. The recipient's body responds by producing, within 8 to 12 days, antibodies that react against the animal serum proteins; the reaction causes injury to blood vessel walls and such allergic symptoms as rash, itching, and swelling of the lymph nodes. Fever, joint pain, spleen enlargement, and even shock may occur (see allergyallergy,
hypersensitive reaction of the body tissues of certain individuals to certain substances that, in similar amounts and circumstances, are innocuous to other persons. Allergens, or allergy-causing substances, can be airborne substances (e.g.
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; hypersensitivityhypersensitivity,
heightened response in a body tissue to an antigen or foreign substance. The body normally responds to an antigen by producing specific antibodies against it. The antibodies impart immunity for any later exposure to that antigen.
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). The reaction subsides as continued production of antibodies removes foreign protein from circulation. A person who has once had a serum injection is sensitized to the serum antigens, and a second injection can bring on the acute reactions typical of anaphylaxisanaphylaxis
, hypersensitive state that may develop after introduction of a foreign protein or other antigen into the body tissues. When an anaphylactic state exists, a second dose of the same protein (commonly an antibiotic such as penicillin, or certain insect venoms) will
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. Today, serum preparations are rarely used. Instead, inoculations of tetanus and diphtheria toxoidstoxoid,
protein toxin treated by heat or chemicals so that its poisonous property is destroyed but its capacity to stimulate the formation of toxin antibodies, or antitoxins, remains.
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 are given in childhood; they confer active immunity against those diseases. Serum sickness may occur in response to proteins other than those found in serum.

Serum Sickness

 

an allergic reaction to foreign proteins in heterogenic serum, generally in serum from the blood of horses. It occurs after the parenteral injection of serum for seroprophylaxis or serotherapy. The incubation period after the first injection ranges from seven to 12 days; with repeated injections, it is considerably shorter.

Serum sickness is manifested by elevated body temperature and a rash appearing at the site of the injection and spreading to the entire body. These symptoms are accompanied by itching, swelling of joints and lymph nodes, and sometimes diarrhea. The illness lasts from several hours to two weeks, and the outcome is generally favorable.

Serum sickness is treated with such antihistamines as dimedrol, warm baths, and rubbing with salicylic alcohol. In severe cases, corticosteroids are administered; in mild cases, no treatment is necessary. The illness is prevented by observing the correct methods of injecting heterogenic sera only after making intracutaneous tests for sensitivity to the given protein and by limiting the use of antitetanic serum through the use of immunization for tetanus and the limitation of tetanic anatoxin injections to cases involving injuries. Other preventive methods involve replacing heterogenic sera with immunoglobulins from human blood and administering antihistamines before injecting heterogenic serum when there is an increased risk of serum sickness owing to repeated injections of serum.

REFERENCE

Ivanov, F. K. Syvorotochnaia bolezn’ i pobochnye oslozhneniia pri lechenii antibiotikami. Moscow, 1967.

serum sickness

[′sir·əm ‚sik·nəs]
(medicine)
A syndrome manifested in 8-12 days after the administration of serum by an urticarial rash, edema, enlargement of lymph nodes, arthralgia, and fever.
References in periodicals archive ?
Both patients had development of meningitis after several doses, had accompanying severe myalgia, and had a milder serum sickness response to an earlier dose.
Serum sickness was suspected on day 13, with a reduction in complement factors (C3, 690 mg/L; C4 <100 mg/L), persistent fever without signs of inflatiitnation, and negative urine culture.
Recognizing the proteins as foreign, the vast majority of people develop over a period of days or weeks some degree of the generalized immune frenzy called serum sickness.
Unpredictable drug reactions including intolerance, idiosyneratic reactions, serum sickness, drug fever, or bullous skin disorders (SJS and TEN) require avoidance of the responsible drug and others of the same chemical class in the future.
Hypersensitivity reactions have been reported with botulinum toxin products (anaphylaxis, serum sickness, urticaria, soft tissue edema, and dyspnea).