Otolaryngology Book

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Skin Test for Horse Serum Sensitivity

Aka: Skin Test for Horse Serum Sensitivity, Horse Serum Sensitivity, Serum Sickness
  1. Indication
    1. Skin Test for Horse Serum Sensitivity prior to use
    2. Many antitoxins and antivenins are from horse serum
  2. Consider alternatives to testing
    1. See Premedication for Allergy Prevention
  3. Efficacy: Controversial in Snake Antivenin (antivenom) use
    1. Advantages to performing skin test prior to antivenin
      1. Possible medicolegal protection only
    2. Disadvantages to skin test prior to antitoxin
      1. Delays treatment (antitoxin administration)
      2. High false-positive rate: 33%
      3. High false-negative rate: 10 to 36%
      4. Has resulted in Anaphylaxis in some patients
    3. References
      1. Jurkovich (1998) J Trauma 28:1032-7 [PubMed]
  4. Technique
    1. 0.1 ml of 1:10 dilution of antitoxin intradermal
    2. Inject at Forearm with 27 gauge
  5. Observe for Allergic Reaction for 20 minutes
    1. Local reaction
      1. Hyperemic areola at injection site > 0.5 cm
    2. Systemic reaction
      1. Fever, chills
      2. Hypotension with decrease Blood Pressure >20 mmHg
      3. Skin rash
      4. Respiratory difficulty
      5. Nausea, Vomiting
      6. Generalized itching
  6. Interpretation: If any signs of reaction
    1. Suggests Horse Serum Sensitivity
    2. Do not use antitoxin

Serum Sickness (C0036830)

Definition (NCI) Delayed-type hypersensitivity reaction to foreign proteins derived from an animal serum. It occurs approximately six to twenty one days following the administration of the foreign antigen. Symptoms include fever, arthralgias, myalgias, skin eruptions, lymphadenopathy, chest pain, and dyspnea. Certain drugs (e.g., antibiotics, anticancer agents, and anti-inflammatory medications) and infectious disorders (e.g., hepatitis B) may also cause serum sickness-like reaction.
Definition (NCI_CTCAE) A disorder characterized by a delayed-type hypersensitivity reaction to foreign proteins derived from an animal serum. It occurs approximately six to twenty-one days following the administration of the foreign antigen. Symptoms include fever, arthralgias, myalgias, skin eruptions, lymphadenopathy, chest marked discomfort and dyspnea.
Definition (MSH) Immune complex disease caused by the administration of foreign serum or serum proteins and characterized by fever, lymphadenopathy, arthralgia, and urticaria. When they are complexed to protein carriers, some drugs can also cause serum sickness when they act as haptens inducing antibody responses.
Definition (CSP) immune complex disease caused by the administration of foreign serum or serum proteins and characterized by fever, lymphadenopathy, arthralgia, and urticaria; when they are complexed to protein carriers, some drugs can also cause serum sickness when they act as haptens inducing antibody responses.
Concepts Disease or Syndrome (T047)
MSH D012713
ICD10 T80.6
SnomedCT 72284000, 213324007, 213322006, 213323001, 213325008
English Serum Sicknesses, Sickness, Serum, Sicknesses, Serum, SERUM SICKNESS, serum reaction (diagnosis), serum sickness (diagnosis), serum intoxication, serum rash, serum reaction, serum intoxication (diagnosis), serum rash (diagnosis), serum sickness, urticaria due to serum (diagnosis), protein sickness, urticaria due to serum, protein sickness (diagnosis), Serum urticaria, Serum Sickness [Disease/Finding], Serum Sickness, Serum sickness (disorder), Protein sickness, Serum sickness, Intoxication by serum, Serum rash, Serum reaction, Transfusion reaction due to serum protein reaction, Urticaria due to serum, Serum rash (disorder), Transfusion reaction due to serum protein reaction (disorder), Urticaria due to serum (disorder), intoxication; serum, protein; sickness, rash; serum, reaction; serum, serum; intoxication, serum; rash, serum; reaction, serum; urticaria, urticaria; serum, Transfusion reaction due to serum protein reaction, NOS
French MALADIE SERIQUE, Séroréaction, Maladie sérique, Maladie du sérum
Portuguese DOENCA DO SORO, Reacção sérica, Doença do soro, Doença do Soro
Spanish ENFERMEDAD DEL SUERO, Reacción del suero, rash del suero, sarpullido del suero, salpullido del suero, enfermedad del suero (trastorno), enfermedad del suero, erupción sérica, intoxicación por suero, rash sérico (trastorno), rash sérico, reacción a una transfusión por reacción de las proteínas del suero (trastorno), reacción a una transfusión por reacción de las proteínas del suero, reacción del suero, urticaria por suero (trastorno), urticaria por suero, urticaria secundaria al suero, Enfermedad del suero, Enfermedad del Suero
German SERUMKRANKHEIT, Serumreaktion, Serumkrankheit
Italian Malattia da siero, Reazione da siero
Dutch serumreactie, exantheem; serum, intoxicatie; serum, proteïne; aandoening, reactie; serum, serum; exantheem, serum; intoxicatie, serum; reactie, serum; urticaria, urticaria; serum, serumziekte, Serumziekte, Ziekte, serum-
Japanese 血清病, 血清反応, ケッセイビョウ, ケッセイハンノウ
Swedish Serumsjuka
Czech sérová nemoc, Sérová reakce, Sérová nemoc
Finnish Seerumitauti
Russian SYVOROTOCHNAIA BOLEZN', СЫВОРОТОЧНАЯ БОЛЕЗНЬ
Polish Choroba posurowicza
Hungarian Szérumreakció, Szérumbetegség
Norwegian Serumsykdom, Serumsyke
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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