Serum Sickness Like Disease in Children

Year 2020, Volume: 8 Issue: 3, 116 - 121, 25.12.2020

Vildan Güngörer , Alaaddin Yorulmaz , Ayşe Yüksel , Şükrü  Arslan

https://doi.org/10.21765/pprjournal.840662

Abstract

Serum sickness and serum sickness-like reactions are the type 3 hypersensitivity reactions that occur in the presence of culprit agents which can be an exogenous protein, drug, bacteria, virus. Clinical symptoms usually begin in 6-21 days after exposure to antigenic stimulation. Typical clinical findings are characterised as fever (10-20%), erythematous rash (95%), polyarthritis and / or polyarthralgia (10-50%), and lymphadenopathy (10-20%). There are no specific laboratory findings and diagnostic criteria for serum sickness-like reaction. Laboratory findings usually include leukocytosis, mildly increased erythrocyte sedimentation rate, and rarely proteinuria and hematuria. Even though there are no diagnostic criteria for serum sickness-like reaction, it can be diagnosed with the presence of fever, rash, arthritis-arthralgia, lymphadenopathy, myalgia which occurs in 1-2 weeks after exposure to an agent that can trigger the disease. Recommended or achieved a consensus for the treatment of the serum sickness-like reaction doesn’t occur and the information about this subject in the literature is limited by the authors’ case reports who share their experiences.

Keywords

child, hypersensitivity, rash, serum sickness

Çocuklarda Serum Hastalığı Benzeri Reaksiyonlar

Abstract

Serum hastalığı ve serum hastalığı benzer reaksiyonlar belli antijenlerin varlığında ortaya çıkan tip III hipersensitivite reaksiyonudur. Semptomlar antijenik uyarıya maruziyet sonrası genelde 6-21 gün sonra başlar. Tip III hipersensitivite reaksiyonuna sebep olan antijen ekzojen yabancı bir protein, ilaç, bakteri, virüs olabilir. Tipik klinik bulgular ateş (%10-20), eritamatöz döküntü (%95), poliartrit ve/veya poliartralji (%10-50) ve lenfadenopati (%10-20) ile karakterizedir. Serum hastalığı benzeri reaksiyon için spesifik labaratuvar bulguları ve tanı kriteri bulunmamaktadır. Labaratuvar bulgularında genellikle lökositoz, hafif artmış eritrosit sedimentasyon hızı ve nadiren proteinüri ve hematüriyi içermektedir. Serum hastalığı benzeri reaksiyonun tanı kriterleri bulunmamakla birlikte hastalığı tetikleyebilecek bir ajana maruziyetten 1-2 hafta sonra gelişen, başka bir nedene bağlanamayan ateş, döküntü, artrit-artralji, lenfadenopati, myalji kliniği ile tanı konulur. Serum hastalığı benzeri reaksiyonda önerilen ve görüş birliği sağlanmış bir tedavi şekli bulunmamaktadır. Bu konuyla ilgili literatürde daha çok yazarların kendi deneyimlerini paylaştıkları vaka bildirimleri mevcuttur.

Keywords

çocuk, döküntü, hipersensitivite, serum hastalığı

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