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Principles of Clinical Diagnosis
Published in Susan Bayliss Mallory, Alanna Bree, Peggy Chern, Illustrated Manual of Pediatric Dermatology, 2005
Susan Bayliss Mallory, Alanna Bree, Peggy Chern
Serum sickness-like reaction Characterized by rash (urticarial, maculopapular, erythema multiforme-like angioedema), fever, arthralgias, lymphadenopathy, eosinophilia (Figure
Incidence of serum sickness following Indian polyvalent antivenom therapy in a cohort of snake-envenomed patients in rural Sri Lanka
Published in Clinical Toxicology, 2023
Subodha Waiddyanatha, Anjana Silva, Supun Wedasingha, Sisira Siribaddana, Geoffrey K. Isbister
Serum sickness-like reactions are a late immune response that appears 5–10 days after exposure. The common triggers for serum sickness-like reactions include antibiotics and vaccines [32–35]. More than half of all the patients with snakebite, including those not receiving antivenom, received flucloxacillin to prevent or treat secondary bacterial infections at the bite site. Although the four patients with serum sickness were treated with flucloxacillin, 214 patients not receiving antivenom were treated with flucloxacillin, and none developed serum sickness. Nonetheless, to differentiate serum sickness from serum sickness-like reaction we would have needed to measure serum compliment C3 and C4 concentrations. In serum sickness, serum C3 and C4 concentrations will be low, whereas in serum sickness-like reactions C3 and C4 concentrations will be normal [36]. This study was conducted over the phone and there were no facilities to measure complement concentrations and therefore no way of excluding possible serum sickness-like reactions in these four patients.
Recent developments in drug hypersensitivity in children
Published in Expert Review of Clinical Immunology, 2019
Ilknur Kulhas Celik, Emine Dibek Misirlioglu, Can Naci Kocabas
In recent years, the use of monoclonal antibodies in the treatment of oncological and autoimmune diseases in children has led to an increase in awareness of hypersensitivity reactions to these antibodies [103]. Data on monoclonal antibody allergy in children are limited to case reports and series. Reactions due to monoclonal antibodies vary according to the type of drug used [104–106]. Reactions are divided into two groups: immediate and nonimmediate. Immediate reactions are subclassified into three groups including cytokine release syndrome, IgE-mediated reactions, and IgG-mediated reactions. Serum sickness-like reaction is the most common nonimmediate symptom associated with monoclonal antibodies [106]. The optimal nonirritant concentrations for SPT and ID test have not been established for monoclonal antibodies in the pediatric population [103]. Since monoclonal antibodies are frequently used in diseases such as cancer where few or no alternative treatment options are available, desensitization may be the only treatment option in their allergies. Although most of the relevant literature concerns adult patients, successful desensitization protocols have also been reported in children [104–106].
Biologics and immunomodulators for treating Crohn’s disease developing after surgery for an initial diagnosis of ulcerative colitis: a review of current literature
Published in Scandinavian Journal of Gastroenterology, 2018
Abhijeet Yadav, Joshua Foromera, Kenneth R. Falchuk, Joseph D. Feuerstein
In another retrospective study of 26 patients with median time between the IPAA and the diagnosis of CD of 4.5 years (range 0.1–16 years), at a short-term follow-up (result of 8 weeks induction therapy), 16/26 patients (62%) had a CR, 6/26 (23%) had a PR, and 4/26 (15%) had no response. All patients received combination therapy with infliximab and an immunomodulator. At long-term follow-up (median 21.5 months, range 3–44 months), 8/24 (33%) either had their pouch resected or had a persistent diverting ileostomy. The pouch, however, remained functional in 16/24 (67%) patients, with either good or acceptable clinical results in 14/24 (58%). Adverse events were infrequent. However, one patient had myalgias and malaise after the first infusion, while another patient had an infusion reaction and 7 months later developed serum sickness-like reaction requiring drug discontinuation [12].