DefinitionThis section has been translated automatically.
Urticaria in serum disease ( allergy, type III reaction) with fever, lymphadenopathy, arthritis, nephritis, angioedema.
EtiopathogenesisThis section has been translated automatically.
Presence of soluble antigen-antibody complexes (type III reaction). Trigger: Early injection of foreign sera and immunoglobulins. Today: antibiotics, sulphonamides, antiepileptics, X-ray contrast medium, acetylsalicylic acid.
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General therapyThis section has been translated automatically.
Removal of the triggering agent. Antihistamines are mostly ineffective. S.a.u. Urticaria, acute.
Internal therapyThis section has been translated automatically.
- Initial exposure: At first exposure, the non-appearance interval is 5-7 days until the first symptoms appear. Glucocorticoids in medium to high dosages such as prednisolone (e.g. Solu Decortin H) 60-100 mg/day or dexamethasone (e.g. Fortecortin Tbl.) 12-16 mg/day. Depending on the clinic, slow dose reduction and balancing.
- Repeated exposure: Immediate reaction with shock and fulminant course. Raise the patient's legs. Large-lumen i.v. access, possibly central venous valve regimen, rapid volume substitution. Dilute adrenalin (e.g. suprarenin) 1:1000 with 0.9% NaCl solution 1:10 and draw up 10 ml (for pre-filled syringes, no dilution is usually necessary). Slow i.v. injection of 0.3-0.5 ml (-1 ml), repeat after 10 min. Intubation if necessary and possible, otherwise coniotomy or tracheotomy, see shock, more anaphylactic. Glucocorticoids high dosage i.v.: Prednisolone 250-500 mg i.v., if necessary higher dosage and after clinical findings also repeated administration. Depending on the clinical findings, gradual dose reduction and later change to an oral preparation: methylprednisolone (e.g. Urbason) or prednisolone.
The use of 10 ml calcium gluconate 10% i.v. is controversial, there is no definite indication.
Heat withdrawal at temperature > 39 °C: calf compress, ice bag in the groin.
LiteratureThis section has been translated automatically.
- King B et al (2003) Adverse skin and joint reactions associated with oral antibiotics in children: The role of cefaclor in serum sickness-like reactions. J Paediatr Child Health 39: 677-681
- Lowery N et al (1994) Serum sickness-like reactions associated with cefprozil therapy. J Pediatr 125: 325-328
- Nigen S et al (2003) Drug eruptions: approaching the diagnosis of drug-induced skin diseases. J Drugs Dermatol 2: 278-299
- Parra FM et al (1994) Serum sickness-like illness associated with rifampicin. Ann Allergy 73: 123-125
- Phillips EJ et al (2003) Serum sickness-like reaction associated with clopidogrel. Br J Clin Pharmacol 56: 583
- Platt et al (1988) Serum sickness-like reactions to amoxicillin, cefaclor, cephalexin and trimethoprim-sulfamethoxazole. J Infect Dis 158: 474-477
- Puyana J et al (1990) Serum sickness-like syndrome associated with minocycline therapy. Allergy 45: 313-315
- Ralph ED et al (2003) Serum sickness-like reaction possibly associated with meropenem use. Clin Infect Dis 36: E149-151
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Outgoing links (15)
Acetylsalicylic acid; Adrenalin; Allergy (overview); Angioedema (overview); Antibiotics; Antihistamines, systemic; Dexamethasone; Glucocorticosteroids; Methylprednisolone; Prednisolone; ... Show allDisclaimer
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
Prof. Dr. med. Peter Altmeyer