Background Serum sickness-like reaction (SSLR) is an acute inflammatory condition affecting predominantly children. The pathophysiology remains unclear, but drugs are considered the main trigger. Objective The aim of this study was to describe the clinical and laboratory features, triggers, and treatment modalities in children diagnosed with SSLR. Methods We conducted a 10-year retrospective cohort study including all paediatric patients (0 to 18 years old) with query SSLR referred to the Adverse Drug Reactions Clinic at the Children’s Hospital of Western Ontario. Diagnostic criteria included acute skin rash plus joint inflammation with or without fever. Results We included 83 patients (47 females). Age ranged from 11 months to 12 years (mean 3.2 years). Amoxicillin was the trigger in 82.7% of patients. The mean time between the exposure to the triggering drug and the development of the symptoms was 8.5 days. Urticaria-like and Erythema multiforme-like lesions were present in 35% and 38.5% of the cases, respectively. Joint inflammation affecting hands/feet was present in 60%. Pruritus, lip/eye swelling, and fever were reported in 33, 31, and 45% of patients, respectively. The lymphocyte toxicity assay (LTA) showed incremental T-cell toxicity in 32 of 34 patients. Children that received treatment with antihistamines/nonsteroidal anti-inflammatory drugs (NSAIDs) plus oral steroids had a mean recovery time shorter than those treated only with antihistamines/NSAIDs (6 versus 8 days; P=0.09). Conclusions In our study, SSLR was mostly triggered by amoxicillin and had a mean time presentation of 8.5 days. Further prospective and well-conducted studies are needed.

中文翻译：

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儿科血清病样反应：一项 10 年回顾性队列研究

背景 血清病样反应 (SSLR) 是一种主要影响儿童的急性炎症性疾病。病理生理学尚不清楚，但药物被认为是主要诱因。目的 本研究的目的是描述诊断为 SSLR 的儿童的临床和实验室特征、触发因素和治疗方式。方法 我们进行了一项为期 10 年的回顾性队列研究，包括所有在西安大略儿童医院的药物不良反应诊所就诊的有查询 SSLR 的儿科患者（0 至 18 岁）。诊断标准包括急性皮疹加关节炎症伴或不伴发热。结果 我们纳入了 83 名患者（47 名女性）。年龄从 11 个月到 12 岁不等（平均 3.2 岁）。阿莫西林是 82.7% 患者的触发因素。从接触触发药物到出现症状的平均时间为 8.5 天。荨麻疹样和多形红斑样病变分别出现在 35% 和 38.5% 的病例中。影响手/脚的关节炎症占 60%。分别有 33%、31% 和 45% 的患者出现瘙痒、唇/眼肿胀和发热。淋巴细胞毒性试验 (LTA) 显示 34 名患者中有 32 名 T 细胞毒性增加。接受抗组胺药/非甾体抗炎药 (NSAID) 加口服类固醇治疗的儿童的平均恢复时间比仅接受抗组胺药/非甾体抗炎药治疗的儿童短（6 天 vs 8 天；P=0.09）。结论 在我们的研究中，SSLR 主要由阿莫西林引发，平均出现时间为 8.5 天。