Serum sickness is a systemic reaction to the introduction into the human body of drugs and proteins that treat diseases of the immune system. Rejection can develop both with primary and with repeated administration of a foreign animal protein. Sometimes the disease provokes the ingestion of antisera, i.e. the liquid portion of the blood containing antibodies.
With this disease, 5-10% of patients who have been treated with treatment serum are found.
Once in the body, a foreign protein begins to circulate in the blood, causing the synthesis of antibodies and forming immune complexes that settle on the tissues, damaging the latter and releasing biologically active substances.
Causes of the disease
Serum sickness sometimes develops when serum is administered against diphtheria, tetanus, rabies, botulism, snake bites, or gas gangrene. A similar syndrome in some cases is observed after the introduction of gamma globulin and an insect bite.
The incubation period lasts 1-2 weeks. There are cases when the clinical picture of serum sickness develops in the first 5 days after the use of the drug, in which case an allergic reaction of the anaphylactic type occurs.
Symptoms
The disease is characterized by pain and swelling at the injection site on the 7-10th day after administration of serum. The patient develops a fever, regional lymph nodes increase, joints are sometimes affected (arthralgia, edema), skin rashes appear in the form of a papular or erythematous pruritic rash, the eye mucosa reacts with conjunctivitis. The defeat of the cardiovascular system is expressed by tachycardia, muffling, expansion of the borders of the heart, and a decrease in blood pressure. In young children, gastrointestinal tract damage is possible, vomiting, frequent stool with mucus, and “intestinal colic” may appear. Sometimes urine reveals protein and traces of blood. Serious illness in severe cases is accompanied by laryngeal edema with asphyxia, hemorrhagic syndrome. With a mild form of the disease, clinical symptoms are observed about 5 days from the onset of the disease, with a severe form - about 3 weeks.
Full recovery is difficult with severe damage to the heart, kidneys, diseases of the nervous system, laryngeal edema and the development of hemorrhagic syndrome.
Treatment
In the treatment of serum sickness, corticosteroid ointments and creams are used to help relieve or reduce sensations from rash and itching.
Antihistamines, which are also aimed at combating itchy skin rashes, reduce the duration of the disease.
To reduce joint pain, the use of non-steroidal anti-inflammatory drugs, such as Naproxen and Ibuprofen, is indicated. In more severe cases, it is customary to prescribe oral corticosteroids (in particular, the drug "Prednisolone").
The use of such drugs and the use of antisera, due to which serum sickness has manifested itself, should be avoided in the future for prevention purposes.
The prognosis of the disease is usually favorable, but sometimes it gives a complication to the kidneys.
Disease prevention .
Before the introduction of serums - diphtheria, tetanus, botulinum antitoxins, rabies serum - a number of preliminary measures are carried out:
- make a scratch, puncture or injection on the forearm, and one drop of diluted serum is lowered from above (1: 100);
- reaction with erythema with a diameter of more than 3 mm is considered positive;
- in case of a negative reaction, a full dose of serum is administered intramuscularly.
It should be noted that even an intradermal test, and even less subcutaneous and intravenous, can cause anaphylactic shock. In this case, it is believed that the introduction of serum intravenously is safer, since the reaction is more controlled. Negative tests also do not always guarantee the absence of anaphylactic shock after the administration of the entire dose, therefore a set of anti-shock medications is provided during such manipulations.
Medicine does not yet know how to prevent serum sickness.