Serum disease

Description:

The serum disease — a special form of the anaphylactic reaction at the person arising after parenteral administration of alien serum is characterized by an enanthesis, lymphadenitis, fever, vascular frustration.

Symptoms of the Serum disease:

Incubation interval at a serum disease of 6 — 11 days, with fluctuations from 1 to 20 days.
Its duration can be reduced till several o'clock or minutes (an anaphylactic form of a serum disease).

The most characteristic and constant sign of a serum disease — rash. Rashes begin usually with a serum injection site. In most cases rash urtikarny, is presented in the form various in size and a form of the pink or red plaques acting over skin level. Elements of rash can be single, but in more hard cases rash extends on all surface of skin, covering a trunk, a face, extremities and a pilar part of the head. Sometimes rash merges in big red spots (erythematic rash). Less often at a serum disease are observed korepodobny, scarlatiniform, and at very heavy current — hemorrhagic rashes. They are followed by a severe itch, burning, feeling of crawling of goosebumps. Puffiness of skin and even a hypodermic basis is quite often noted.

Along with changes on skin lymphadenitis is almost constantly noted. Increase in lymph nodes begins with regional in relation to a serum injection site. At heavy disease separate lymph nodes are surprised, occasionally increase chest, occipital and zaushny. Lymph nodes are soft, are painless or poorly painful, the sizes from haricot to pigeon egg. Developing of hypostasis is possible (especially a century and lips), very seldom hypostasis covers skin of a trunk and extremities. Almost constant symptom are the arthralgias covering joints of extremities and grudino-clavicular, intervertebral and other joints are more rare. Intensity of an arthralgia fluctuates very widely. Sometimes there are synovites; in hard cases muscle pain and on the course of nervous trunks is noted.

Approximately at 2/3 patients with a serum disease fever is observed. Temperature increases sharply, lasts from several hours to 3 weeks and has various character (subfebrile, remittiruyushchy etc.). Along with fever other displays of the general toxicosis (the general weakness, perspiration, a loss of appetite, tachycardia, hypotonia) are noted.

In some cases the serum disease strengthens the dying-away displays of a disease concerning which serum was appointed. So, at patients with tetanus in the period of the begun reconvalescence becomes more expressed a lockjaw, at patients with botulism — a diplopia etc.

At a heavy current of a serum disease emergence of a bronchospasm, hypostasis of a throat, a hyperthermia, spasms, heart and vascular failure is possible.
In blood — a leukopenia, a relative lymphocytosis, increase in SOE. Considerable decrease in a caption of a complement in blood is characteristic.

The wavy current of a serum disease — disappearance and new emergence of the main clinical symptoms later 1 — 3 days after the seeming recovery is quite often observed.
The heaviest reaction — the acute anaphylaxis arising in response to parenteral administration of heterogeneous protein is observed in terms of several minutes to 1 — 2 h after administration of serum (usually repeated). It arises suddenly and is most brightly shown by the patient's oglushennost, suffocation (bronchospasm), temperature drop of a body, sharp hypotonia, tachycardia. There are an excitement, sensation of fear, convulsive reduction of muscles, and then a loss of consciousness, short wind, throat hypostasis, cyanosis. Quite often on skin generalized rash like small tortoiseshell develops. Only immediate delivery of health care can prevent a lethal outcome.

Reasons of the Serum disease:

Development of a serum disease is caused by introduction more often than heterogeneous serums, and also any medicines (antibiotics, streptocides, proteinaceous drugs etc.). In a course of a disease the great value gets organism sensitization degree.
In emergence of a serum disease the leading place belongs to interaction of antigen and antibodies, mainly IgG and IgE. The heaviest display of a disease is the acute anaphylaxis.

Treatment of the Serum disease:

In hard cases of a serum disease, especially at damages of heart, joints, a nervous system, apply corticosteroids, as a rule, a short course. At the expressed joint phenomena non-steroidal anti-inflammatory drugs (Brufenum, Voltarenum, analginum, sometimes delagil) are appointed, at hypostases — diuretics (lasixum, Triampur compositum). Antihistaminic drugs (Suprastinum, Pipolphenum, tavegil, etc.), use adrenaline, drugs of calcium widely, they are rather effective at easier forms of a disease. For reduction of an itch recommend heat baths, rubdowns of 1 — 5% spirit solution of menthol. According to indications appoint also other symptomatic means. Hospitalization are subject patients with an acute anaphylaxis, and also with heavy and medium-weight forms of a serum disease.