ABSTRACT
Serum sickness is a Type III immune complex mediated hypersensitivity
reaction which is characterized by fever, rashes, arthralgia and
haematuria which occurs within 2 weeks of exposure of the offending
agent. Medications including streptokinase are one of the rare and
significant causes of Serum sickness due to presence of non-homologous
protein. Streptokinase is used as a thrombolytic condition in different
heart diseases including mitral valve stenosis. Although the condition
is self-limiting, severe cases require intervention including NSAIDS,
Steroids and Plasmapheresis. A 36-year-old female presented with the
fever, arthralgia, shortness of breath after receiving thrombolytic
treatment of streptokinase 3 days back for prosthetic valve thrombosis.
Laboratory findings included increased ESR and CRP levels indicative of
inflammatory disease, however all other rheumatological markers were
negative. Based on the clinical history and investigations, Serum
Sickness secondary to streptokinase was made. The condition was managed
with supportive care, leading to resolution of the symptoms
spontaneously. This case report highlights the importance of early
recognition and management of serum sickness. Though serum sickness is a
rare but is a significant complication of streptokinase therapy. Early
diagnosis and appropriate management can prevent the severe outcome of
the patient. Clinician should be vigilant for any thrombolytic
complication during the treatment course.