Dorothy FarrarSerum sickness
Serum sickness is a severe allergic reaction of the immune system to foreign protein. In addition, serum sickness can also be caused by various medications. Since it is a severe, complication-heavy and possibly life-threatening clinical picture, must be treated immediately.
What is serum sickness?
Serum sickness is an immediate allergy type 3. This corresponds to a so-called anaphylactic shock caused by an antigen-antibody reaction with foreign protein or other toxic substances. Since the severe allergy can quickly lead to damage to the vital internal organs, there is a danger to life without timely medical help due to impending multi-organ failure. From a certain degree of organ damage, help is no longer possible. The allergic reaction to foreign proteins always depends on the type and amount of antigen to which an allergy exists.
Causes
Serum sickness is any form of severe allergy caused by foreign protein. The cause is therefore foreign protein from animals or plants. Typically, serum sickness is observed as a severe vaccine reaction after administration of vaccine sera whose antibodies are of animal origin, such as equine serum. The antibodies are formed by administration of the antigen in the bloodstream of the horse and are then later contained in the human vaccine.
In addition, venous and intramuscularly administered antibiotics also play a clinical role as triggers of serum sickness. The pathomechanism is such that some antibiotics attach to human immunoglobulins and this complex is then recognized by the immune system as alien and combated. As a result, the immune system reacts with an excessive defense reaction, which sets in motion a whole cascade of immunological mechanisms that are clinically difficult to control from a certain degree of severity. Another important cause of serum sickness is the insect bite by bees, wasps or hornets.
Symptoms and course
Typical symptoms of serum sickness:
Despite the wide variety of antigens that can cause serum sickness, the clinical symptoms and course are similar. This depends crucially on the type, quantity and point of entry of the antigen. In severe allergic disposition, millionths of a gram of an antigen are enough to cause an allergy. It is known that the course of serum sickness is much milder with drugs as triggers than is the case with equine serum for vaccination. Severe courses occur in insect bites, especially by bees.
Once contact with the allergen has occurred, oedema, redness, itching and fever occur either immediately or up to 3 weeks after such contact, although these symptoms may occur individually or in combination. With injections or stings, redness with coarse swelling can often be observed at the injection site.
Due to the intravascularly circulating immune complexes, pain and inflammation can also occur in joints or organs, because the immune complexes can be deposited there and cause a renewed reaction of the immune system. General symptoms may also include nausea, vomiting and headaches, in case of danger to life also somnolence.
Diagnosis
The diagnosis results from the usually dramatic clinical full picture with oedema formation, convulsive tendency and shortness of breath. If the patient is responsive, the diagnosis can be quickly confirmed on the basis of the own medical history. If other people can report on the development of the disease, then this foreign anamnesis can also be very helpful for the emergency doctor with regard to the triggering allergen.
Treatment and therapy
Due to the severity of the disease, the therapy, which must be carried out very promptly, is always symptom-oriented at first. Because in the short time available, the antigen cannot be eliminated from the bloodstream. So the treatment aims to stop the excessive allergic reaction to prevent further cell or organ damage. In milder cases, the active ingredients acetylsalicylic acid and antihistamines have proven themselves for immediate therapy.
The symptoms should regress within a few minutes after application. In severe and life-threatening hypersensitivity reactions, the use of glucocorticoids or adrenaline may also be required. For rapid systemic action, these substances must be administered intravenously. Due to the centralization of the circulation, it is not always easy for medical staff to lay a venous access in allergic shock.
After successful therapy, the symptoms either disappear immediately or usually completely within a week. It could be demonstrated that the antigen-antibody complexes, also called immune complexes, are gradually broken down by phagocytosis. Phagocytes are certain white blood cells, Leukocytes , which have the ability to absorb antigens and immune complexes and thus render them harmless.
Prevention
If it is known that a patient is allergic to foreign proteins, any therapy with human serum preparations should be avoided. If vaccinations are necessary, the risk-benefit factor must be clarified individually by a doctor. If necessary, such a complication-prone vaccination can also be carried out under separate medical supervision. Patients who are aware of their Bee venom allergy should be equipped with an emergency kit that can be life-saving in an emergency. The emergency set contains, among other things, a PEN for self-application of cortisone or adrenaline.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.