Incidence of immediate and delayed hypersensitivity to Centruroides antivenom.

• Abstract: STUDY OBJECTIVE: To assess the incidence and course of immediate and delayed hypersensitivity to Centruroides antivenom. METHODS: We performed a 12-month prospective observation study, with telephone follow-up, evaluating the incidence of anaphylaxis or anaphylactoid reactions and serum sickness after Centruroides antivenom administration. The setting for the study was a poison control center and tertiary care toxicology treatment center. Participants included all patients who received Centruroides antivenom, and no interventions were performed. RESULTS: For immediate hypersensitivity reactions, 116 patients with grade III or IV envenomation received Centruroides antivenom; 77 of these patients were younger than 13 years. Three patients completed the infusion despite development of rash. A fourth patient with a history of atopy and asthma received epinephrine infusion and an inhaled beta-agonist for transient wheezing that quickly resolved; she was admitted for observation. Nine patients without hypersensitivity reactions were admitted for social reasons, for inappropriate sedation from drugs used before antivenom, or to rule out aspiration; all were discharged within 24 hours. The remaining 106 patients were discharged from the emergency department after resolution of symptoms. Thus 4 of 116 patients had immediate reactions. For patients with delayed reactions, 17 patients were lost to follow-up. Of 99 remaining patients, serum sickness developed in 61% (n=60), as defined by using liberal criteria. Serum sickness responded to oral steroids, antihistamines, or both; mean duration of symptoms with medication was 2.8 days. CONCLUSION: Anaphylactic reactions are uncommon after Centruroides antivenom infusion. Self-limited serum sickness that is easily controlled with corticosteroids and antihistamines commonly follows the use of Centruroides antivenom.
• Authors: F LoVecchio, S Welch, J Klemens, S C Curry, R Thomas (Affiliation: Department of Medical Toxicology, Good Samaritan Medical Center, Phoenix, AZ 85006, USA. frankl at samaritan.edu)
• Journal: Annals of emergency medicine (Ann Emerg Med) Vol. 34 Issue 5 Pg. 615-9 (Nov 1999) ISSN: 0196-0644 [Print] UNITED STATES
• PMID: 10533009 (Publication Type: Journal Article)

Chemical References

• Antivenins
• Scorpion Venoms

Topics

• Adult
• Anaphylaxis (chemically induced, epidemiology)
• Animals
• Antivenins (adverse effects)
• Arachnidism (therapy)
• Child
• Drug Hypersensitivity (epidemiology, etiology)
• Female
• Humans
• Hypersensitivity, Delayed (chemically induced)
• Hypersensitivity, Immediate (chemically induced)
• Incidence
• Male
• Prospective Studies
• Scorpion Venoms
• Scorpions
• Serum Sickness (chemically induced)