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Clinical features of serum sickness after Australian snake antivenom.
Toxicon 2015; 108:181-3T

Abstract

Serum sickness is a delayed immune reaction in which the immune system responds to a protein in antiserum as a potentially harmful substance and mounts an IgG-mediated antibody response. A 32 year-old female patient had systemic envenoming following a bite by a red-bellied black snake (Pseudechis porphyriacus). She was treated with Tiger snake antivenom and recovered over 24 h and did not develop myotoxicity. She then presented with local pain, itching and swelling, which was partially treated with antihistamines. Eleven days after the bite she presented again with symptoms of worsening serum sickness including rash on the upper legs, joint and muscle pain in arms, ankles and knees, and nausea. The patient was prescribed five days of prednisone 50 mg/day, antihistamine 10 mg/day and analgesia 1000 mg/day and improved over 2 days. She had no further problems on follow up at 4 months. This case highlights that serum sickness can cause significant effects after the treatment of snake envenoming. It develops 5-14 days after antivenom administration and has characteristic clinical and laboratory features. Severe cases of serum sickness can result in morbidity but it appears to respond well to corticosteroid treatment.

Authors+Show Affiliations

Clinical Toxicology Research Group, The University of Newcastle, Newcastle, NSW, Australia. Electronic address: Nicole.Ryan@newcastle.edu.au.Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle, NSW, Australia.Clinical Toxicology Research Group, The University of Newcastle, Newcastle, NSW, Australia; Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle, NSW, Australia.

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26525657

Citation

Ryan, Nicole M., et al. "Clinical Features of Serum Sickness After Australian Snake Antivenom." Toxicon : Official Journal of the International Society On Toxinology, vol. 108, 2015, pp. 181-3.
Ryan NM, Downes MA, Isbister GK. Clinical features of serum sickness after Australian snake antivenom. Toxicon. 2015;108:181-3.
Ryan, N. M., Downes, M. A., & Isbister, G. K. (2015). Clinical features of serum sickness after Australian snake antivenom. Toxicon : Official Journal of the International Society On Toxinology, 108, pp. 181-3. doi:10.1016/j.toxicon.2015.10.012.
Ryan NM, Downes MA, Isbister GK. Clinical Features of Serum Sickness After Australian Snake Antivenom. Toxicon. 2015 Dec 15;108:181-3. PubMed PMID: 26525657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical features of serum sickness after Australian snake antivenom. AU - Ryan,Nicole M, AU - Downes,Michael A, AU - Isbister,Geoffrey K, Y1 - 2015/10/23/ PY - 2015/08/10/received PY - 2015/10/17/revised PY - 2015/10/20/accepted PY - 2015/11/4/entrez PY - 2015/11/4/pubmed PY - 2016/10/13/medline KW - Red-bellied black snake KW - Serum sickness KW - Snake envenomation KW - Tiger snake antivenom SP - 181 EP - 3 JF - Toxicon : official journal of the International Society on Toxinology JO - Toxicon VL - 108 N2 - Serum sickness is a delayed immune reaction in which the immune system responds to a protein in antiserum as a potentially harmful substance and mounts an IgG-mediated antibody response. A 32 year-old female patient had systemic envenoming following a bite by a red-bellied black snake (Pseudechis porphyriacus). She was treated with Tiger snake antivenom and recovered over 24 h and did not develop myotoxicity. She then presented with local pain, itching and swelling, which was partially treated with antihistamines. Eleven days after the bite she presented again with symptoms of worsening serum sickness including rash on the upper legs, joint and muscle pain in arms, ankles and knees, and nausea. The patient was prescribed five days of prednisone 50 mg/day, antihistamine 10 mg/day and analgesia 1000 mg/day and improved over 2 days. She had no further problems on follow up at 4 months. This case highlights that serum sickness can cause significant effects after the treatment of snake envenoming. It develops 5-14 days after antivenom administration and has characteristic clinical and laboratory features. Severe cases of serum sickness can result in morbidity but it appears to respond well to corticosteroid treatment. SN - 1879-3150 UR - https://www.unboundmedicine.com/medline/citation/26525657/Clinical_features_of_serum_sickness_after_Australian_snake_antivenom_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-0101(15)30115-X DB - PRIME DP - Unbound Medicine ER -