Serum Sickness Like Disease in Children

Serum sickness and serum sickness-like reactions are the type 3 hypersensitivity reactions that occur in the presence of culprit agents which can be an exogenous protein, drug, bacteria, virus. Clinical symptoms usually begin in 6-21 days after exposure to antigenic stimulation. Typical clinical findings are characterised as fever (10-20%), erythematous rash (95%), polyarthritis and / or polyarthralgia (10-50%), and lymphadenopathy (10-20%). There are no specific laboratory findings and diagnostic criteria for serum sickness-like reaction. Laboratory findings usually include leukocytosis, mildly increased erythrocyte sedimentation rate, and rarely proteinuria and hematuria. Even though there are no diagnostic criteria for serum sickness-like reaction, it can be diagnosed with the presence of fever, rash, arthritis-arthralgia, lymphadenopathy, myalgia which occurs in 1-2 weeks after exposure to an agent that can trigger the disease. Recommended or achieved a consensus for the treatment of the serum sickness-like reaction doesn’t occur and the information about this subject in the literature is limited by the authors’ case reports who share their experiences.