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.