Serum sickness: signs, symptoms, complications, treatment
Serum sickness refers to an allergic condition, an immune response to injections, or taking preparations based on a foreign protein.The least obvious is the immunopathological reaction to the human( homologous) protein, more often diagnoses pathology for animal serum.It is sometimes found only after repeated administration, and the first application can pass without negative consequences.
In this article we will describe what is serum sickness, its pathogenesis, symptoms and treatment, show photos of patients.
Features of the disease
So, serum sickness as a type of allergic reaction. According to statistics, serum sickness develops in the case of the introduction of serum in 10% of people.
Even the method of injecting is of great importance.So, if you stab the drug intramuscularly, the danger of an allergic reaction is much lower than with the intravenous route.
General clinical manifestations are the same for all age groups.
Serum sickness in the child
Serums are divided into 2 types:
- Protein homologous preparations. This medicine contains fractions or whole plasma of blood.Its low allergenicity is explained by the high content of immunoglobulins, since it is prepared on the basis of blood of 100 people.
- The heterologous preparations include 2 subcategories of sera-antilymphocytic and antitoxic.
Next, consider the causes of serum sickness and the mechanism of its development.
Reasons for the occurrence of
Serum injections are used in the following diseases and conditions:
- gas gangrene;
- snake bite;
The mechanism of development is long, sometimes up to 2 weeks, since for the appearance of a pathological immune response, antigens, other immune complexes must form.When serum is circulating in the blood, these complexes can settle on tissues, damage them.In rare cases, clinical symptoms occur on days 1-5 after the application of serum.Here the mechanism of the allergic reaction is somewhat different, a large role is assigned to the reacting IgE, which provokes symptoms according to the anaphylactic type.
The clinical picture is most pronounced after 10 days after the injection. The area of the skin where the needle was inserted, swollen, becomes painful.A person with serum sickness can suffer from the following symptoms:
- rash with itching: rashes in the form of erythema or papules;
- lymph nodes are enlarged;
- reduced blood pressure;
For severe cases of serum sickness are characterized:
- hemorrhagic syndrome;
- breathing stenotic type;
- laryngeal edema.
The peculiarity of the mild forms of the disease lies in the fact that the recovery comes after 4-5 days.With a complicated form, the clinical picture is observed for 3 weeks.
Diagnostics, treatment at home and in the clinic of serum sickness are further considered.
After the onset of any signs of serum sickness, they are referred to an allergist.To establish an accurate diagnosis, a blood test is performed in which the number of immunoglobulins E, eosinophils and other standard indices is determined.
Diagnosis is based on the characteristic acute manifestations inherent in the disease.It is similar to some infectious diseases, so make sure to differentiate.
Polymerase chain reaction and serological methods are very informative.These diagnostic tests give an answer about the number of antibodies.If the assay about the development of serum sickness has been confirmed by the tests described above, x-ray, ultrasound and other examinations are prescribed.
With a slight itching, when other symptoms do not bother, it is sufficient to use menthol alcohol as a topical treatment for rubbing.It is not forbidden to use other antipruritic drugs.If the articular syndrome is concerned, the places of its appearance are treated with Diclofenac, Brufen, Indometacin.
On what drugs are treated for whey disease syndrome in children and adults, we will tell below.
By medicamentous method
- In the mild form of , serum sickness is prescribed routine, calcium gluconate or sodium chloride solutions, and ascorbic acid.Complement the therapy with individually selected antihistamines.
- In complex cases, requires the administration of glucocorticosteroids.If anaphylactic reaction is manifested, then they must put a tourniquet above the injection site and make several injections of adrenaline.Still enter Suprastinum or Dimedrolum.In the absence of improvements in the condition, prescribed droppers with saline and hydrocortisone, repeat injections of antihistamines.To prevent a negative effect on the internal organs, cardiac glycosides are administered.Euphyllin is indicated in bronchospasm.
In this case:
- As the condition improves, the dosage of hydrocortisone is gradually reduced until it is replaced with a tablet form.Their dose should also decrease gradually, but only under the strict supervision of the doctor.
- Hospitalization is always indicated in the elderly and childhood, low blood pressure, with serious pathologies and an unclear diagnosis.
Prevention of serum sickness
For prophylaxis, it is recommended to follow an even sequence in each case:
- Turn the patient's forearm toward himself internally and make a small puncture or cut.They need to drop 1 drop of serum, which is supposed to be applied.Preliminary it is necessary to dissolve it in a solution of sodium chloride isotonic with a ratio of 1: 100.If after 20 minutes erythema is formed, which occupies more than 3 mm of the skin surface, the manipulation is discontinued, since the reaction is positive and the injection is prohibited.
- Children are vaccinated if there is no history of allergies and a negative reaction to the measures described above.Subcutaneously injected no more than 0.02 ml.
- If a child has atopic diathesis, the drug should be diluted with a 1: 1000 ratio.This solution is drilled on the scratch surface and, in the absence of negative symptoms, the drug is administered in a ratio of 1: 100.Further, it is necessary to observe the patient's condition for about 30 minutes.
- If the reaction is completely negative, then the serum is administered intramuscularly in the usual dose.
- When intravenously injecting the drug, first inject 0.5 ml of a solution of serum and sodium chloride( 1:10), and after 30 minutes, add the remaining dose( 1:20).
Before starting the injection, you should always make sure that there are a number of medications necessary for anti-shock therapy, because even at the stage of the test on the skin an anaphylactic shock can occur in a person.Anti-shock drugs should be always, even in the presence of a negative reaction in the test, as it can not be a complete guarantee of the absence of an allergic reaction.
For anaphylactic shock and other complications that lead to serum sickness, read below.
Currently, the risk of any serious complications after serum injection is very low.When an allergic reaction is made as soon as possible developed therapeutic tactics to prevent their occurrence.Among the complications there are such conditions as:
- anaphylactic shock;
- kidney failure.
Adverse events are indicated by complications such as laryngeal edema, renal, nervous system and heart damage.In other cases, the forecast remains more than favorable.