Serum sickness: causes of development, prognosis
Serum sickness is a systemic reactionon the introduction into the human body of drugs and proteins, which treat diseases of the immune system. Rejection can develop both in the primary and in the reintroduction of an alien animal protein. Sometimes the disease provokes the ingestion of antisera into the body, i.e. liquid part of the blood containing antibodies.
With this disease, there are 5-10% of patients who have been treated with therapeutic serum.
The foreign protein that enters the body beginscirculate in the blood, causing the synthesis of antibodies and forming immune complexes that settle on tissues, damaging the latter and secreting biologically active substances.
Causes of the disease
Serum sickness sometimes develops whenthe introduction of serum against diphtheria, tetanus, rabies, botulism, snake bites or gas gangrene. A similar syndrome in some cases is observed after the introduction of gamma globulin and an insect bite.
The incubation period lasts 1-2 weeks. There are cases when the clinical picture of serum sickness develops in the first 5 days after the drug is administered, in this case there is an allergic reaction as anaphylactic.
Disease is characterized by pain andswelling at the injection site on the 7-10th day after the introduction of serum. The patient has a fever, regional lymph nodes increase, joints are sometimes affected (arthralgia, edema), there are rashes on the skin in the form of papular or erythematous itching rash, the mucous eye reacts with conjunctivitis. The defeat of the cardiovascular system is expressed by tachycardia, muffling of tones, expansion of the borders of the heart, lowering of arterial pressure. In young children, lesions of the digestive tract may occur, vomiting, frequent stool with mucus, "intestinal colic" may appear. Sometimes in the urine reveal protein and traces of blood. Serum sickness in severe course is accompanied by laryngeal edema with asphyxia, hemorrhagic syndrome. With mild disease, clinical symptoms are observed about 5 days from the onset of the disease, with severe form - about 3 weeks.
Full recovery is difficult with severe heart, kidney, nervous system, laryngeal edema and hemorrhagic syndrome.
In the treatment of serum sickness, corticosteroid ointments and creams are used to help relieve or reduce the sensation of rash and itching.
Reduce the duration of the disease antihistamines, which are also aimed at combating itchy skin rashes.
To reduce pain in the joints shownuse of non-steroidal anti-inflammatory drugs, such as Naproxen and Ibuprofen. In more severe cases, it is customary to prescribe oral corticosteroids (in particular, Prednisolone).
The use of such medicines and the use of antisera, which caused serum sickness, should be avoided in the future for prevention purposes.
The prognosis of the disease is usually favorable, but sometimes it complicates the kidneys.
Prevention of disease.
Before the introduction of sera - diphtheria, tetanus, botulinum antitoxins, anti-rabies sera - a number of preliminary measures are carried out:
- make a scratch, puncture or an injection on the forearm and drop one drop of diluted serum from the top (1: 100);
- a reaction with erythema more than 3 mm in diameter is considered positive;
- with a negative reaction intramuscularly administered a full dose of serum.
It should be noted that even holdingintradermal dough, and the more so subcutaneous and intravenous can cause anaphylactic shock. In this case, it is believed that the administration of serums is intravenously safer, since the reaction is more controlled. Negative tests also do not always guarantee the absence of anaphylactic shock after the introduction of the entire dose, therefore a set of anti-shock medicines is provided for such manipulations.
Medicine does not yet know how to prevent serum sickness.