Serum sickness-like reaction following an administration of the first dose of inactivated COVID19 vaccine

Chaijaras, Sasipim; Seree-aphinan, Chutima; Rutnin, Suthinee; Ngamjanyaporn, Pintip; Rattanakaemakorn, Ploysyne

doi:10.1016/j.jdcr.2021.11.004

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…A 43-year-old female patient with a serum sickness-like reaction after receiving the first dose of an inactivated COVID-19 vaccine (CoronaVac; Sinovac, Beijing) was reported by Chaijaras et al [ 20 ]. In addition to severe myalgia and arthralgia, the rashes were accompanied by fever, generalized malaise, and cervical lymphadenopathy [ 24 ]. Our case adds to evidence of inactivated COVID-19 immunization to the list of disease triggers; serum sickness-like reactions linked to this vaccine may be characterized as hypersensitivity responses [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Case Report of Serum Sickness-like Reaction following the First Dose of the Chimpanzee Adenovirus-Vectored AstraZeneca COVID-19 Vaccine, ChAdOx1

Alzaidi

AlOtaibi

et al. 2023

Vaccines

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Serum sickness-like reaction from serum sickness is critical. Serum sickness-like reaction has comparable symptoms to serum sickness, but their underlying pathophysiology is distinct. This delayed hypersensitivity response was first characterized as a drug-induced reaction and is uncommon in adults; it is more common in children. COVID-19 vaccinations are now being routinely given in the COVID-19 period, and adverse reactions to immunization have been recorded. We present a case of COVID-19 vaccination-induced serum sickness-like reaction which developed after receiving the first dose of AstraZeneca COVID-19 vaccine.

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Section: Discussionmentioning

confidence: 99%

Case Report of Serum Sickness-like Reaction following the First Dose of the Chimpanzee Adenovirus-Vectored AstraZeneca COVID-19 Vaccine, ChAdOx1

Alzaidi

AlOtaibi

et al. 2023

Vaccines

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“…They are most associated with ß-lactam antibiotics (especially cefaclor and amoxicillin), sulfonamides, fluoroquinolones, aromatic anticonvulsants, tetracyclines, minocycline, metronidazole, bupropion, and other drugs including biologicals ( Lawley et al, 1984 ; Platt et al, 1988 ; Heckbert et al, 1990 ; Weiss and Smith, 2020 ). This type of reactions can also develop as a result of vaccine administration including recent cases of SSLR to inactivated COVID-19 vaccine ( Chung et al, 2021 ; Chaijaras et al, 2022 ). The condition is defined by sudden appearance of skin rash (usually urticaria-like) and arthritis usually manifested 1–3 weeks after drug exposure, which can be accompanied by fever, lymphadenopathy, eosinophilia, and rarely renal involvement ( Del Pozzo-Magana et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

The role of in vitro testing in pharmacovigilance for ß-lactam-induced serum sickness-like reaction: A pilot study

et al. 2022

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Background: Current pharmacovigilance (PV) methods for detection of adverse drug reactions (ADRs) fail to capture rare immune-mediated drug hypersensitivity reactions (DHRs) due to their scarcity and the lack of clear diagnostic criteria. Drug-induced serum sickness-like reactions (SSLRs) are rare type of DHRs that occur in susceptible patients 1–3 weeks after exposure to the culprit drug with ß-lactam antibiotics being the most associated drugs. The diagnosis of drug induced SSLR is difficult due to the lack of safe and reliable diagnostic tests for identifying the culprit drug. The lymphocyte toxicity assay (LTA) is an in vitro test used as a diagnostic tool for drug hypersensitivity reactions (DHRs).Objective: To evaluate the role of the LTA test for diagnosing and capturing SSLR due to ß-lactam antibiotics in a cohort of patients.Methods: Patients were recruited from patients referred to the Drug Hypersensitivity Clinic at Clinic at London Health Science Centre with suspicion of drug allergy. Twenty patients (10 males and 10 females) were selected to be tested to confirm diagnosis. Demographic data was collected form the patents and blood samples were withdrawn from all patients and from 20 healthy controls. The LTA test was performed on all subjects and data is expressed as percentage increase in cell death compared to control (vehicle without the drug).Results: In the result of LTA tests performed on samples from the selected 20 patients. There was a significant (p < 0.05) concentration-dependent increase in cell death in cells isolated from patients as compared to cells from healthy controls when incubated with the drug in the presence of phenobarbitone-induced rat liver microsomes.Conclusion: Giving its safety and good predictive value the LTA test has very strong potential to be a useful diagnostic tool for ß-lactam-induced SSLR. The test procedure is relatively simple and not overly costly. Further studies including other drug classes are needed to evaluate the utility of the LTA test for SSLR due to other drugs.

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Multiple drugs

2022

Reactions Weekly

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Multiple drugsSerum sickness-like reaction and rebound effect: case report A 43-year-old woman developed serum sickness-like reaction (SSLR) following immunisation with sars-cov-2-vaccineinactivated-sinovac-biotech against COVID-19. Additionally, she experienced rebound of SSLR following tapering of colchicine, prednisolone, unspecified antihistamines and unspecified steroid for SSLR [not all routes, dosages and durations of treatments to reactions onsets stated].The woman received the first dose of sars-cov-2-vaccine-inactivated-sinovac-biotech [CoronaVac; inactivated COVID19 vaccine]. However, 4 days after receiving the first dose, she presented with pruritic blanchable erythematous macules and patches and excoriated papules and plaques on her trunk and extremities, with post-inflammatory hyperpigmentation. Some lesions showed a feature resembling reticulate erythema. The rashes started as a single patch on the chest and became generalised within 9 days and appeared randomly and did not follow a pattern of centrifugal distribution. The rashes were accompanied by fever, generalised malaise, severe myalgia, arthralgia and cervical lymphadenopathy. Various laboratory tests and investigations were performed. The overall clinical presentation, the temporal relationship with the sars-cov-2-vaccine-inactivated-sinovac-biotech, together with the normal complement levels, favored the diagnosis of sars-cov-2-vaccine-inactivated-sinovac-biotech-related SSLR.The woman was treated with high-dose oral prednisolone 1 mg/kg daily, colchicine 1.2mg daily, antihistamines and a moderatepotency topical steroid [drugs not specified]. She achieved rapid improvement of her condition in less than a week. Thus, a 2 week taper of all treatment drugs was attempted; however, the symptoms recurred with this tapering regimen [rebound effect]. Therefore, prednisolone was reintroduced at 15mg daily with gradual tapering guided by erythrocyte sedimentation rate levels. After 2 months of treatment, inflammatory markers normalised, allowing a slow withdrawal of prednisolone treatment while other drugs were continued. Due of the prolonged course and severity of the illness, further vaccine doses were canceled. The SSLR was reported to the vaccine adverse event reporting system.

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Serum sickness-like reaction following an administration of the first dose of inactivated COVID19 vaccine

Cited by 4 publications

References 9 publications

Case Report of Serum Sickness-like Reaction following the First Dose of the Chimpanzee Adenovirus-Vectored AstraZeneca COVID-19 Vaccine, ChAdOx1

Case Report of Serum Sickness-like Reaction following the First Dose of the Chimpanzee Adenovirus-Vectored AstraZeneca COVID-19 Vaccine, ChAdOx1

The role of in vitro testing in pharmacovigilance for ß-lactam-induced serum sickness-like reaction: A pilot study

Multiple drugs

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