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Serum sickness–like reactions (SSLRs) refer to adverse reactions that have symptoms similar to those of serum sickness (type III immune complex hypersensitivity) but in which immune complexes are not found.[1]:127

Causes[edit]

Agents that have been implicated in serum sickness–like reactions include cefaclor, amoxicillin, sulfonamides, tetracyclines, ciprofloxacin, nonsteroidal anti-inflammatory drugs, barbiturates, carbamazepine, propranolol, thiouracil, and allopurinol. Metabolites of these drugs might bind with tissue proteins inappropriately, eliciting an acute inflammatory response that typically develops 7–14 days after initiation of the offending agent. Acute hepatitis B will sometimes be complicated with this syndrome, which often resolves with the onset of jaundice.

Pathogenesis[edit]

Serum sickness–like reaction is named for its clinical similarity to serum sickness, in which immune complexes are deposited in the skin, joints, and other organs. True serum sickness, a type III hypersensitivity reaction, results in fever, lymphadenopathy, arthralgias, cutaneous eruptions, gastrointestinal disturbances, proteinuria, and significant decreases in serum complement levels; it was originally described after patients were infused with equine immunoglobulins.

To explain the world pdf free download. In contrast, serum sickness–like reactions are specific drug reactions that are not associated with circulating immune complexes.

Although the exact pathogenesis is poorly understood, serum sickness–like reactions are thought to originate from an abnormal inflammatory reaction that occurs in response to defective metabolism of drug byproducts generated during pharmacologic therapy; the metabolic flaw could be a maternally-inherited trait. In vivo hepatic drug biotransformation studies have shown greater lymphocyte killing in subjects with a known history of serum sickness–like reactions than in control subjects.

Diagnosis[edit]

The reaction generally includes a constellation of fever; urticarial polycyclic wheals (a rash that can look similar to hives with small swellings that overlap each other [2]) with central clearing on the trunk, extremities, face, and lateral borders of the hands and feet; oral edema without mucosal involvement; lymphadenopathy; arthralgias; myalgias; and mild proteinuria. Case reports have noted the absence of fever in serum sickness–like reactions to amoxicillin. Laboratory abnormalities include normal or mild decreases in serum C3, C4, and CH50 levels, and mild proteinuria.1,3-5 In contrast to true serum sickness, renal and hepatic involvement is rare. Significant decreases in serum C3, C4, and CH50, reported in the literature for true serum sickness, are rarely described in serum sickness–like reaction.

Management[edit]

Serum sickness–like reaction is an acute self-limited reaction with an ultimately favorable outcome. Treatment is typically symptomatic, but hospitalization may be required for severe cases. While optimal treatment strategies for serum sickness–like reactions are not clearly defined in the literature, discontinuation of the suspected agent combined with use of antihistamines, corticosteroids and NSAIDs for symptom control is an appropriate therapeutic route. Case reports have shown that treatment with prednisone, 60 mg daily, and high doses of H1 and H2 antihistamines help resolve the arthralgias and myalgias within 24 hours and the remaining symptoms within 48–72 hours

See also[edit]

Notes[edit]

  1. ^James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN0-7216-2921-0.
  2. ^http://www.nzdoctor.co.nz/in-print/2011/september-2011/7-september-2011/dermatology-update.aspx[permanent dead link]

References[edit]

  • Mener DJ, Negrini C, Blatt A: Itching like mad. American Journal of Medicine. 2009; 8(122): 732-734.
Retrieved from 'https://en.wikipedia.org/w/index.php?title=Serum_sickness-like_reaction&oldid=1036538796'
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An American Sickness

Author :Elisabeth Rosenthal
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A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 'This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.

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NOTE: This is a summary guide and is meant as a companion to, not a replacement for, the original book.Our summaries are designed to teach you important lessons in a cost-effective and timely manner. They are coherent, concise and complete, highlighting the main ideas and concepts contained in the original books. Non-essential information is removed to save the reader hours of reading time. Save time and money by completing your reading list. Please follow this link to get regular new released book summary guides: https: //amazon.com/author/cityprint THE BOOK: An Amеrісаn Sісknеѕѕ (2017) tаkеѕ аn hоnеѕt lооk at the ѕtаtе оf thе Amеrісаn health-care ѕуѕtеm and frаnklу diagnoses іtѕ mаnу ailments. Whеn bіg buѕіnеѕѕ started tаkіng оvеr whаt wеrе оnсе сhаrіtаblе оrgаnіzаtіоnѕ, things bеgаn to gо truly wrоng. Rоѕеnthаl рrеѕеntѕ vаluаblе іnfоrmаtіоn оn hоw tо rеduсе hеаlth-саrе bіllѕ аnd nоt gеt taken fоr a rіdе bу grееdу hоѕріtаlѕ and over-prescribing dосtоrѕ.ABOUT THE AUTHOR: Dr. Elіѕаbеth Rosenthal, аftеr ѕреndіng mаnу уеаrѕ as a correspondent аnd reporter fоr thе Nеw York Tіmеѕ, bесаmе еdіtоr-іn-сhіеf of Kaiser Hеаlth News, a position ѕhе ѕtіll hоldѕ. A graduate оf Harvard Mеdісаl Sсhооl, ѕhе hаѕ іnvаluаblе еxреrіеnсе as an ER рhуѕісіаn аnd extensive training in іntеrnаl medicine.INTRODUCTION: Ovеr thе lаѕt fеw decades, hеаlth care hаѕ bесоmе a major роіnt оf debate іn thе Unіtеd Stаtеѕ. Pоlіtісіаnѕ оf аll stripes аrguе over thе рrісе оf mеdісіnе and different аррrоасhеѕ tо hеаlth insurance, but, thоugh everyone ѕееmѕ to аgrее that ѕоmеthіng isn't working, nо оnе ѕееmѕ tо hаvе a clear іdеа of exactly how to fіx іt. Hоw did іt соmе tо thіѕ? In thеѕе blіnkѕ, we'll dіvе dеер into thе US health-care system аnd еxрlоrе whу thе Unіtеd States аррrоасhеѕ trеаtmеnt оf thе іll vеrу dіffеrеntlу thаn mоѕt other Wеѕtеrn nаtіоnѕ. Wе'll lооk аt thе hіѕtоrу оf health care, as wеll as thе сurrеnt ѕіtuаtіоn аnd роѕѕіbіlіtіеѕ fоr thе future. Thеrе mау be a wау to ѕаvе a ѕуѕtеm that mоѕt раrtіеѕ agree is ѕісk. Yоu'll аlѕо fіnd out -whу prescription drugѕ аrе so еxреnѕіvе іn thе Unіtеd Stаtеѕ; -that hоѕріtаlѕ mаkе money on tests уоu mіght nоt nееd; аnd -whаt уоu саn dо tо start reducing hеаlth-саrе соѕtѕ now.

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