Who gets serum sickness?
Serum sickness typically followed exposure to foreign, non-human proteins, especially antivenoms and antitoxins made in horse, e.g., rattlesnake antivenom used in the USA. More recently, reactions have been reported with the increasing use of thymoglobulin and chimeric monoclonal antibody therapy (biological response agents). Thymoglobulin (anti-thymocyte globulin) is made in rabbits. It is used particularly in the perioperative period following solid organ transplants to reduce the post-operative doses of immunosuppressive drugs. The incidence of serum sickness due to thymoglobulin in renal transplant recipients has been estimated to be between 7 and 27%. There is an increased risk of developing serum sickness to thymoglobulin if there has been a significant past exposure to rabbits or horses. Chimeric monoclonal antibodies are a group of biologic agents that are being used with increasing frequency for many immunological disorders such as rheumatoid arthritis, psoriasis and in cancer
