Predictive Factors on Hospitalization Period in Serum Sickness like Reaction in Iranian Patients

Abstract

Background: Serum sickness-like reactions (SSLR), although rare in clinical practice, most commonly occurs in children following drug consumption specially following antibiotic therapy. The aim of this study was evaluation of predictive factors on hospitalization period in serum sickness like reaction. Method: All patients with SSLR diagnosis who admitted in a tertiary children hospital in Tehran (Children’s Medical Centre) during 2009-2012 enrolled in this study. In addition to demographic data, fever, cutaneous eruptions and arthralgia/arthritis, other organ involvement and the name of drugs which used during 2-3 past weeks, were registered. Laboratory findings were assessed in all pa tients. Severity of SSLR was defined based on the duration of admission and end organ involvement. Findings: Overall, among 70 patients, just 4.3% had previous history of SSLR. Skin rash was generalized in 94.3% patients. Joint involvement and fever were observed in 85.7% and 64.3%, respectively. History of recent upper respiratory tract infection was found in 48.6%. Fifty patients (71.4%) had his tory of recent antibiotics therapy. Cefixime and furazolidon were the most common used antibiotics (25.7% and 21.4%, respectively). Sever SSLR was seen in 34.4%of patient. Erythrocyte sedimentation rate (ESR), peripheral leukocyte count (WBC), thrombocytosis and positive C-reactive protein (CRP more than 2+) were significantly higher in patient with prolong hospitalization (P<0.05). Conclusion: Based on our findings, high ESR rate, positive CRP, thrombocytosis and WBC count can be as predictive factors of severity in SSLR.