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一项前瞻性队列研究于2022年10月至2024年9月在加拿大伦敦儿童医院开展，纳入0至18岁表现为皮疹伴关节痛或水肿的患儿，旨在描述儿童血清病样反应（SSLR）的临床与实验室特征。27例患者中男性占59%，就诊时平均年龄4岁；阿莫西林是最常见诱因（85.2%），皮疹以环状形态最常见，超声排除了真性关节炎。皮疹约5天消退，关节痛约4天缓解；全身性激素可加速关节痛缓解，但未缩短病程。淋巴细胞毒性试验在58.3%的病例中确认药物因果关系，并与环状皮疹及T细胞活化标志物升高相关。研究认为，上述发现对儿童SSLR的诊断、管理和预后具有重要意义。
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不含 2026 年，仅展示最近 5 个完整年度。
prospective OR cohort OR serum OR sickness-like OR reactions OR children数据更新时间：2026/11/01 22:31仅展示最近 5 个完整年度，不包含 2026 年 YTD。
年初至今数量单独展示，不与完整年度直接比较。
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BACKGROUND: Serum sickness-like reaction (SSLR) is an adverse reaction mainly to drugs, infectious agents, or vaccines, characterized by the presence of rash, arthralgia, or arthritis and occasionally fever. OBJECTIVE: This systematic review aimed to analyze the clinical characteristics, implicated agents, symptomatology, and management of SSLR. METHODS: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Case reports and case series were included owing to the paucity of data in the literature on SSLR. We performed a comprehensive search of Embase and MEDLINE. Data extracted included age, comorbidities, medication exposure, time to reaction, symptoms, diagnostic criteria, and treatment modalities. Descriptive statistics were employed to summarize the data. We used χ2 test was used to compare categorical variables between adults and children. RESULTS: A total of 44 studies involving 468 patients were included. Antibiotics were more associated with SSLR in children than in adults (P < .01). β-Lactam antibiotics, particularly amoxicillin (72.1%), were the leading implicated agents. Dermatologic manifestations, primarily maculopapular rashes, were present in 100.0% of cases whereas joint symptoms occurred in 78.7%. Corticosteroids were effective in resolving symptoms in most cases. CONCLUSIONS: Serum sickness-like reaction presents diagnostic challenges owing to overlapping symptoms with other drug reactions. β-Lactams are the most common implicated agents, particularly in pediatric populations. Systemic corticosteroids may provide relief, but standardized guidelines for diagnosis and management are needed. Further research is essential to clarify the pathophysiology and optimize treatment strategies for SSLR.
, were observed. The risk of a positive pDPT with cefprozil in patients with confirmed amoxicillin-induced SSLR was 13% (2/16), but only 4% (2/49) in the overall cohort—indicating a relatively low risk. As cefprozil shares more structural similarity with amoxicillin, cross-reactivity with other cephalosporins is likely even lower. In conclusion
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Antibiotics are commonly prescribed to treat a variety of bacterial infections. As with all medications, hypersensitivity reactions may occur and clinicians should be able to recognize them accurately and recommend appropriate management. Antibiotic related hypersensitivity reactions may be one of four different types: Type I reactions, which are IgE mediated and may lead to anaphylaxis; Type II reactions that are antibody-mediated and may result in thrombocytopenia, neutropenia, or hemolytic anemia; Type III reaction that involves an immune complex formation such as vasculitis; and Type IV reactions that consist of four subtypes and typically include a rash of varying level of severity with or without systemic signs and symptoms. Herein, we describe the mechanisms of different types of allergic reactions to commonly prescribed antibiotics and offer recommendations for management. Further, we briefly refer to antibiotic reactions that mimic hypersensitivity reactions but are not immune mediated, such as pseudoallergies and serum sickness-like reactions.
Serum sickness-like reactions (SSLR) consist of urticaria or urticarial-like rashes with joint pain and variable features of fever, angioedema and gastrointestinal distress. Allergists typically evaluate patients in the clinic for an implicated medication, such as antibiotic or vaccine. Although SSLR may be mistaken for classical serum sickness or anaphylaxis due to overlapping clinical features, there is minimal evidence for type I or type III hypersensitivity reactions. Despite recent studies showing antibiotic allergy is rarely verified, patients rarely undergo allergy evaluation. A difficulty is that there is no agreement about challenge procedures- multiple day dosing protocols lead to a risk for hives and joint pain which does not occur with single day challenges. Additionally, tolerance of either challenge protocol does not fully prevent rashes and repeat episodes of SSLR in all non-allergic children who used the culprit or an unrelated antibiotic again. Due to the distressing symptoms, lack of abortive therapies, and uncertainty with challenge, many healthcare professionals and families may prefer to bypass allergy evaluation and continue lifelong avoidance. However, medication allergy labels may be associated with poor health outcomes. Well-designed prospective studies are needed to provide better insight into the diagnosis, effective treatments, and true recurrence rates.
Background: Beta-lactam allergy (BLA) labels are common in children but often disproven when formally evaluated. This diagnostic discrepancy leads to higher health-care costs and increased adverse outcomes. Beta-lactam antibiotics are associated with a variety of adverse reactions in children. A serum sickness-like reaction (SSLR) is one adverse reaction that is complex in its diagnosis and management due to its heterogeneous clinical presentation and poorly understood mechanism. This unclear presentation and diagnostic criteria can be confusing for patients, families, and health-care professionals, leading to allergy evaluation hesitancy. With updated drug practice parameters that support the utility of oral drug challenges for patients with SSLRs related to beta-lactams, barriers remain for these patients to seek allergy evaluation. Objectives: The objective was to assess caregiver perspectives on BLA delabeling and identify barriers to drug challenge testing in children with a history of SSLRs. Methods: We conducted an 18-question telephone survey with 14 caregivers of children with a history of beta-lactam-associated SSLR. The survey assessed attitudes toward allergy delabeling, understanding of challenge testing, and perceived barriers to testing. Results: Most caregivers demonstrated an understanding of the importance of allergy delabeling; however, the comfort level with challenge testing varied, depending on the setting, provider, and perceived risk of SSLR recurrence. Of the caregivers, 62.4% reported feeling comfortable with their child's pediatrician performing the testing. When asked about their concerns about testing, nearly 50% of caregivers expressed concern about the possibility of a repeated SSLR. Conclusion: The overall positive attitude toward BLA testing, especially in a primary care setting, highlights an opportunity to make testing more accessible for patients. However, the unpredictable nature of SSLRs seems to contribute to caregiver reservations about pursuing testing for their child. To mitigate this, targeted education from health-care professionals, such as physicians, advanced practice providers, and nurses, may reduce caregiver hesitancy and facilitate BLA delabeling for patients with SSLRs.
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A serum sickness-like reaction (SSLR) to drug administration usually consists of cutaneous rash, arthralgia/arthritis, and, often, fever. This entity rarely has been discussed in the dermatologic literature. We describe the case of a 3-year-old girl with urticaria, fever, and arthralgia that appeared 8 days after starting cefaclor therapy for otitis media.
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