Serum sickness describes a delayed immune system response, either to certain kinds of medications or to antiserum (given after a person has been bitten by a snake or to counter exposure to rabies, for example). Serum is the clear fluid part of blood. Serum sickness is similar to an allergy, in that the body mistakenly identifies a protein from the antiserum or medication as harmful and activates the immune system to fight it off. Today, the most common cause of serum sickness is the antibiotic penicillin.
Serum sickness will usually develop within 7 to 10 days after initial exposure, but sometimes it can take as long as 3 weeks. If you are exposed again to the substance, serum sickness tends to develop faster (within 1 to 4 days), and only a very small amount of the substance may cause an intense response.
Signs and Symptoms
The first signs of serum sickness are redness and itching at the injection site. Other signs and symptoms include:
What Causes It?
Antigens, proteins the body mistakenly identifies as harmful, cause your immune system to produce antibodies. These antibodies bind with the antigens and build up on the layers of cells that line the heart, blood vessels, lymph vessels, and other body cavities. This causes inflammation and other symptoms of serum sickness.
Penicillin is the most common cause of serum sickness. Other causes include:
Who is Most At Risk?
You are more likely to suffer from serum sickness if:
What to Expect at Your Provider's Office
Your doctor will look for typical symptoms and ask if you have been recently exposed to any antiserum. Your doctor may order blood and urine tests.
Treatment for serum sickness is aimed at reducing symptoms. Your doctor may prescribe antihistamines or analgesics (NSAIDs), along with topical medications to relieve itching or rash. In serious cases, your doctor may prescribe corticosteroids, such as prednisone. Normally, there is no need for hospitalization. Fever typically gets better within 48 to 72 hours of treatment.
Complementary and Alternative Therapies
If you suspect you have serum sickness, you should see a doctor immediately and receive conventional medical treatment. Some complementary and alternative therapies (CAM) may support conventional treatment by helping to reduce inflammation and stabilize your immune system, but no scientific studies have been done on the effectiveness of CAM therapies for serum sickness. Although certain CAM therapies may help relieve symptoms, others could make them worse. Take any herb, supplement, or medication only under your doctor's supervision.
Nutrition and Supplements
The following nutrients may help support your immune system and reduce allergic reactions, though there is no scientific evidence they will be effective for serum sickness. As noted, some may make serum sickness worse. Talk to your doctor before taking any of these supplements.
Following these nutritional tips may help reduce risks and symptoms:
Traditional Chinese Medicine and acupuncture can help lessen the body's tendency toward allergic hypersensitivity reactions.
DO NOT use massage to treat serum sickness as it may promote inflammation and lower blood pressure.
Serum sickness usually improves in 7 to 10 days, with full recovery in 2 to 4 weeks. However, it may lead to nervous system disorders and a life-threatening allergic reaction called anaphylaxis, so it is important to get medical treatment.
Health care providers should monitor seriously ill people for rare instances of myocarditis (inflammation of the heart muscle) and peripheral neuritis (nerve inflammation).
Bhat KPL, Kosmeder JW 2nd, Pezzuto JM. Biological effects of resveratrol. Antioxid Redox Signal. 2001;3(6):1041-64.
Bonds RS, Kelly BC. Severe serum sickness after H1N1 influenza vaccination. Am J Med Sci. 2013;345(5):412-3.
Bope and Kellerman: Conn's Current Therapy, 2012. 1st. ed. Philadelphia, PA: Elsevier Saunders; 2011.
Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.
Jacob A, Chaves L, Eadon MT, Chang A, Quigg RJ, Alexander JJ. Curcumin alleviates immune-complex-mediated glomerulonephritis in factor-H-deficient mice. Immunology. 2013;139(3):328-37.
Maheshwari RK, Singh AK, Gaddipati J, Srimal RC. Multiple biological activities of curcumin: a short review. Life Sci. 2006;78(18):2081-7.
Marx: Rosen's Emergency Medicine. 7th ed. St. Louis, MO: Elsevier Mosby; 2009.
Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-47. Shi J, Yu J, Pohorly JE, Kakuda Y. Polyphenolics in grape seeds-biochemistry and functionality. J Med Food. 2003;6(4):291-9.
Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.
Williams JE. Review of antiviral and immunomodulating properties of plants of the Peruvian rainforest with a particular emphasis on Una de Gato and Sangre de Grado. Altern Med Rev. 2001;6(6):567-79.
Wolverton. Comprehensive Dermatologic Drug Therapy. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2007.
Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.
Review Date: 3/24/2015
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.