Abstract

BARREIRA, Patrícia  and  GOMES, Eva. Serum sickness-like reaction associated with drugs intake in pediatric age. Rev Port Imunoalergologia [online]. 2013, vol.21, n.4, pp.267-275. ISSN 0871-9721.

Background: Serum sickness-like reaction (SSLR) is a rare disease, usually self -limited and with favorable prognosis, that may be associated with the administration of drugs. Objective: To describe cases of SSLR observed on a drug allergy unit of a pediatric hospital. Methods: Retrospective analysis of SSLR cases observed on the drug allergy unit of the Immunoalergo logy Department of Hospital Maria Pia between 2006 and 2012. Results: 23 patients were included, 13 female. The age at the time of the reaction ranged from 1 to 7 years (median 3 years). Beta -lactam antibiotics were the suspected drug in all cases. All reactions were delayed, appearing on average at day 8 of treatment (± 3 days). Skin lesions and arthralgias/arthritis occurred in all patients. Laboratory evaluation during the reaction was conducted in 91% of patients, including complete blood count, sedimentation rate, determination of complement fractions and serologic tests. Most reactions were treated in the emergency department and 11 patients were admitted. All patients had a favorable outcome, with a median of 8 days for complete resolution(1 -45 days). Results of the allergological work-up: specific IgE for beta -lactam was performed in all patients (positive in two cases). Skin prick tests and intradermal tests were performed in one patient, with a positive late reading. The challenge test was performed in four patients (negative in all cases). Conclusions: There are no studies on the prevalence of SSLR associated with drugs intake. Clinical manifestations can mimic other disorders and can arise just after the drug treatment. A high degree of suspicion is required to the diagnosis, which is determined by the temporal relationship between drug intake and the onset of clinical signs. The diagnostic procedures play a secondary role in this disease.

Keywords : Children; drug hypersensitivity; serum sickness-like reaction.

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