Serum sickness-like reaction

Some types of allergic reaction, for example immediate or delayed-type skin allergies, serum-sickness-like reactions and anaphylactic reactions, may occur in a proportion of patients given penicillin treatment. There is some, but not complete, cross-allergy with cephalosporins. 

Serum sickness-like reactions (erythema multiforme or skin rashes accompanied by polyarthritis, arthralgia and, frequently, fever) have been reported these reactions usually occurred following a second course of therapy. Signs and symptoms occur after a few days of therapy and resolve a few days after drug discontinuation with no serious sequelae. 

Nausea, serum sickness-like reaction (marked by fever and joint pain usually occurs... 

Nausea, unusual bruising or bleeding, serum sickness-like reaction (marked by fever and joint pain usually occurs after the second course of therapy and resolves after the drug is discontinued)... 

Nausea, unusual bruising/bleeding, serum sickness-like reaction Rare... 

A delayed serum sickness-like reaction may occur 1-2 weeks after anti-TNF therapy in 1% of patients. These reactions consist of myalgia, arthralgia, jaw tightness, fever, rash, urticaria, and edema and usually require discontinuation of that agent. Positive antinuclear antibodies and anti-double-stranded DNA develop in a small number of patients. Development of a lupus-like syndrome is rare and resolves after discontinuation of the drug. 

Amfebutamone has been associated with a variety of generalized sensitivity reactions (SEDA-25, 17 SEDA-27, 28), including urticaria and serum sickness-like reactions. 

Two cases of serum sickness-like reactions have been reported in association with amfebutamone when used as an aid to smoking cessation (15,16). Both patients developed localized swellings of the fingers and hands, urticaria, and arthralgia. In both cases treatment with antihistamines and corticosteroids produced rapid relief of symptoms. 

In three other patients (two women, one man) a serum sickness-like reaction developed 6-21 days after the start... 

McCollom RA, Elbe DH, Ritchie AH. Bupropion-induced serum sickness-like reaction. Ann Pharmacother 2000 34(4) 471-3. 

Peloso PM, Baillie C. Serum sickness-like reaction with bupropion. JAMA 1999 282(19) 1817. 

Tripathi A, Greenberger PA. Bupropion hydrochloride induced serum sickness-like reaction. Ann Allergy Asthma Immunol 1999 83(2) 165-6. 

Waibel KH, Katial RR. Serum sickness- like reaction and bupropion. J Am Acad Child Adolesc 2004 43 509. 

Cefaclor has been associated with a high incidence of adverse joint and skin reactions. This unusual serum sickness-like reaction appears to be due to an inherited defect in the body s handling of cefeclor metaboUc products. 

In three other patients (two women, one man) a serum sickness-like reaction developed 6-21 days after the start of amfebutamone treatment (14). The symptoms, arthralgia, pruritus, and tongue swelling, abated within 2 weeks of treatment with oral corticosteroids. Serum sickness reactions to drugs are rare, and it will be important to find out whether amfebutamone carries an increased risk of this unusual reaction. 

It is stiU uncertain whether cefaclor-associated serum sickness-like reactions correspond to true hypersensitivity. It has indeed been suggested that they may result from inherited defects in the metabolism of reactive intermediates and may be a unique adverse reaction requiring biotransformation of the parent drug (187). A lymphocyte-based cytotoxicity assay has shown that cefaclor metabolites, as generated by murine hepatic microsomes, mediated cytotoxicity among patients with... 

Lowery N, Kearns GL, Young RA, Wheeler JG. Serum sickness-like reactions associated with cefprozil therapy. J Pediatr 1994 125(2) 325-8. 

Platt R, Dreis MW, Kennedy DL, Kuritsky JN. Serum sickness-like reactions to amoxicillin, cefaclor, cephalexin, and trimethoprim-sulfamethoxazole. J Infect Dis 1988 158(2) 474-7. 

Kearns GL, Wheeler JG, Childress SH, Letzig LG. Serum sickness-like reactions to cefaclor role of hepatic... 

Dermatological adverse effects are not uncommon with griseofulvin and are of considerable variety. The following have been described urticaria (28,29), photosensitivity eruptions (30), erythema multiforme (31), morbilliform rashes (32), serum sickness-like reactions (33), fixed drug eruption (29,34,35), Stevens-Johnson syndrome (36), vasculitis (37), toxic epidermal necrolysis (38,39), and lupus erythematosus (40,41). 

Colton RL, Amir J, Mimouni M, Zeharia A. Serum sickness-like reaction associated with griseofulvin. Ann Pharmacother 2004 38(4) 609-ll. 

Treatment with infliximab can be associated with the formation of human antichimeric antibodies. Such antibodies were rarely detected in patients with rheumatoid arthritis who were also taking methotrexate, and low titers were detected in about 13% of patients with Crohn s disease. Their clinical relevance is unclear, although their presence has sometimes been associated with an increased risk of infusion reactions, the occurrence of serum sickness-like reactions after delayed re-treatment, and a shorter duration of response. 

Itraconazole 200 mg bd for 2 weeks caused a serum sickness-like reaction in a 53-year-old woman with Meniere s disease (48). 

Park H, Knowles S, Shear NH. Serum sickness-like reaction to itraconazole. Ann Pharmacother 1998 32(11) 1249. 

A serum sickness-like reaction clinically similar to classical serum sickness can result from the administration of a number of non-protein drugs, such as tetracyclines, penicillins, cephalosporins (50). Minocycline has been reported to cause serum sickness (29,51). 

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