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Case reports have noted the absence of fever in serum sickness–like reactions to amoxicillin. Laboratory abnormalities include normal or mild decreases in serum C3, C4, and CH50 levels, and mild proteinuria. In contrast to true serum sickness, renal and hepatic involvement is rare.
In pharmacologic (supraphysiologic) doses, glucocorticoids, such as prednisone, dexamethasone, and hydrocortisone are used to suppress various allergic, inflammatory, and autoimmune disorders. They are also administered as posttransplantory immunosuppressants to prevent the acute transplant rejection and graft-versus-host disease .
Prednisone is a glucocorticoid medication mostly used to suppress the immune system and decrease inflammation in conditions such as asthma, COPD, and rheumatologic diseases. [3] It is also used to treat high blood calcium due to cancer and adrenal insufficiency along with other steroids . [ 3 ]
Sometimes prednisone will be prescribed to prevent a possible late-phase type I hypersensitivity reaction. [56] Severe allergic reactions (anaphylaxis) may require treatment with an epinephrine pen, an injection device designed for use by a non-healthcare professional when emergency treatment is warranted. A second dose is required in 16–35% ...
By contrast, uncontrolled use of conventional (escalating dose) immunotherapy (hyposensitization not EPD) for general allergic conditions was believed to be responsible for at least 29 deaths in the UK, and is now banned in the United Kingdom except in hospital under close observation. [18]
Others must be bioactivated into a toxic compound that will in turn bind to proteins. The second criterion of cellular damage can come either from a toxic drug/drug metabolite, or from an injury or infection. These will sensitize the immune system to the drug and cause a response. Idiosyncratic reactions fall conventionally under toxicology.
In general, corticosteroids are grouped into four classes, based on chemical structure. Allergic reactions to one member of a class typically indicate an intolerance of all members of the class. This is known as the "Coopman classification". [43] [44] The highlighted steroids are often used in the screening of allergies to topical steroids. [45]
Prednisolone can also be used for allergic reactions ranging from seasonal allergies to drug allergic reactions. [25] Prednisolone can also be used as an immunosuppressant for organ transplants. [7] [26] Prednisolone in lower doses can be used in cases of adrenal insufficiency due to Addison's disease. [27] [28]
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