Introduction
Streptokinase is a widely used fibrinolytic agent for treating
cardiovascular diseases, particularly in developing countries due to its
cost-effectiveness1. Isolated from hemolytic
streptococci, Streptokinase forms complexes with plasminogen to activate
it into plasmin, which then dissolves blood clots and helps in improving
reperfusion and left ventricular function in different cardiovascular
diseases2. Being derived from bacterial protein, it
can result in allergic reactions and bleeding, which are common adverse
events. Patients might also have bradycardia and hypotension, along with
fever, shivering, and rashes, as well as anaphylactic
reactions3. Few case reports have reported serum
sickness as a complication of Streptokinase therapy. Alexopoulos et al.
(1984) have reported serum sickness as a complication of intravenous
streptokinase when used for acute myocardial
infaraction4. Serum Sickness is a Type III immune
complex mediated hypersensitivity reaction which was first recognized in
a patient who received heterologous antisera in the early 1990s. The
symptoms usually occur after 1 to 2 weeks after exposure to offending
agents and is a self-limited disease5. Although the
condition is self-limiting, severe cases may require intervention.
Treatment often involves discontinuing the offending agent and
administering corticosteroids, which can lead to complete
recovery6.
In this we report a rare case from Tertiary Teaching Hospital of a
36-year-old female, with a known history of mitral valve stenosis
secondary to Rheumatic Heart Disease who underwent Streptokinase
treatment and presenting with Serum Sickness. This case underscores the
complexities of managing prosthetic valve thrombosis and highlights the
importance of monitoring and addressing potential complication of
thrombolytic therapy.