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Serum sickness

  • Definition

    Serum sickness is a reaction similar to an allergy. Specifically, it is an immune system reaction to certain medications, injected proteins used to treat immune conditions, or antiserum, the liquid part of blood that contains antibodies that help protect against infectious or poisonous substances.

    See also: Immune response

    Causes, incidence, and risk factors

    Plasma is the clear fluid portion of blood. It does not contain blood cells, but it does contain many proteins, including antibodies, which are formed as part of the immune response to protect against infection.

    Antiserum is produced from the plasma of a person or animal that has immunity against a particular infection or poisonous substance. Antiserum may be used to protect a person who has been exposed to a potentially dangerous microorganism against which the person has not been immunized. For example, you may receive a certain type of antiserum injection if you have been exposed to tetanus or rabies. This is called passive immunization. It gives you immediate, but temporary, protection while your body develops an active immune response against the toxin or microorganism.

    During serum sickness, the immune system falsely identifies a protein in antiserum as a potentially harmful substance (antigen). The result is a faulty immune system response that attacks the antiserum. Immune system elements and the antiserum combine to form immune complexes, which cause inflammation and other symptoms.

    Certain medications (such as penicillin, cefaclor, and sulfa) can cause a similar reaction. Unlike other drug allergies, which occur very soon after receiving the medication again, serum sickness develops 7 - 21 days after the first exposure to a medication.

    Injected proteins such as antithymocyte globulin (used to treat organ transplant rejection) and rituximab (used to treat immune disorders and cancers) cause serum sickness reactions.

    Blood products may also cause serum sickness.