Demographic and clinical characteristics of patients with serum sickness-like reaction

Abstract

In this study, we aimed to review the demographic, clinical, and laboratory characteristics of patients who were followed up and treated with the diagnosis of serum sickness-like reactions (SSLR) in our pediatric rheumatology clinic retrospectively and emphasize the importance of early diagnosis and treatment. The files of 29 patients who were hospitalized in the pediatric rheumatology clinic between September 2016 and March 2017 with the diagnosis of type 3 hypersensitivity reaction were reviewed retrospectively. Patient records including C-reactive protein, erythrocyte sedimentation rate, serum electrolytes, blood glucose, urea, and liver function were recorded by using the computerized patient database. The gender, age, length of hospital stay, accompanying clinical findings, family history of atopy, preceding infection, and drug usage data were obtained from the files of the patients. Twenty-nine patients with the diagnosis of type 3 hypersensitivity reaction were evaluated. Fifteen (51.7%) of the patients were male and 14 (48.3%) were female. The male to female ratio was 1.07. The age distribution of patients ranged from 18 to 192 months (mean ± SD 100.66 ± 53.75 months). The hospitalization duration was 3-16 days (mean ± SD 5.14 ± 3.20 days). The use of many drugs, especially antibiotics, has increased even in the treatment of viral upper air way infections. As a result, side effects have also increased. The most important of these is SSLR. However, this disease is not well recognized by clinicians.

A review of cutaneous hypersensitivity reactions in infants: From common to concerning

“…Laboratory findings may include leukocytosis, elevated erythrocyte sedimentation rate, and mild proteinuria or hematuria; unlike true serum sickness, complement levels are normal . Histopathology is marked by a mixed dermal inflammatory infiltrate and edema without vasculitis .…”

“…SSLR is managed with discontinuation of any predisposing medications with gradual resolution of symptoms over weeks to months. Supportive care with antihistamines and pain management is generally sufficient; however, systemic corticosteroids may be considered if symptoms are severe …”

Serum sickness‐like reaction following initiation of elexacaftor/tezacaftor/ivacaftor therapy

“…The patient is a 12-year-old male with a diagnosis of CF Christine Schafer MD 3 James Ko MD 3 José A. Torres Garcia MD, MHA 1 Ilana S. Rosman MD 3,4 Carrie Coughlin MD 3 Andrea Coverstone MD 1 Andrew J. White…”

Serum Sickness-Like Reaction: Drug-Induced Cutaneous Disease in a Child

“…From a clinical perspective it resembles Serum Sickness-Like Reaction (SSLR), presenting clinical similar findings. These are both rare diseases that can manifest with urticarial rash, fever, and arthralgia, mainly differing by their etiopathology and laboratory findings [1,2]. SSLR pathogenesis remains unclear but is probably related to an inflammatory response to drug metabolites, more commonly, following beta-lactams use.…”

“…SSLR pathogenesis remains unclear but is probably related to an inflammatory response to drug metabolites, more commonly, following beta-lactams use. It is not mediated by immunocomplexes and does not manifest hypocomplementemia [1,2] .…”