WordNet

want to have; "Id like a beer now!"
a kind of person; "Well not see his like again"; "I cant tolerate people of his ilk" (同)ilk
a similar kind; "dogs, foxes, and the like", "we dont want the likes of you around here" (同)the like, the likes of
equal in amount or value; "like amounts"; "equivalent amounts"; "the same amount"; "gave one six blows and the other a like number"; "the same number" (同)same
resembling or similar; having the same or some of the same characteristics; often used in combination; "suits of like design"; "a limited circle of like minds"; "members of the cat family have like dispositions"; "as like as two peas in a pod"; "doglike devotion"; "a dreamlike quality" (同)similar
be fond of; "I like my nephews"
feel about or towards; consider, evaluate, or regard; "How did you like the Presidents speech last night?"
find enjoyable or agreeable; "I like jogging"; "She likes to read Russian novels"
(mechanics) the equal and opposite force that is produced when any force is applied to a body; "every action has an equal and opposite reaction"
a response that reveals a persons feelings or attitude; "he was pleased by the audiences reaction to his performance"; "John feared his mothers reaction when she saw the broken lamp"
a bodily process occurring due to the effect of some antecedent stimulus or agent; "a bad reaction to the medicine"; "his responses have slowed with age" (同)response
doing something in opposition to another way of doing it that you dont like; "his style of painting was a reaction against cubism"
an idea evoked by some experience; "his reaction to the news was to start planning what to do"
extreme conservatism in political or social matters; "the forces of reaction carried the election"
defectiveness or unsoundness; "drugs have become a sickness they cannot cure"; "a great sickness of his judgment"
a feeling of pleasure and enjoyment; "Ive always had a liking for reading"; "she developed a liking for gin"
an amber, watery fluid, rich in proteins, that separates out when blood coagulates (同)blood_serum

PrepTutorEJDIC

…‘を'『好む』,‘が'好きである / 《しばしば否定文で,またwould,《英》shouldと共に用いて》…‘を'望む,…したい / 『好む』;望む / 《複数形で》好み,好きな事
(外観・性質などが)…『に似た』,のような / (やり方,程度などが)…『と同じように』 / …『らしい』,にふさわいし / 《おもに話》たとえば…のような / 《名詞の前にのみ用いて》(性質・外観などが)同じの,(数量が)等しい / 《補語にのみ用いて》似ている,そっくりで / たぶん,おそらく(probably) / (…に)似た人(物),(…と)同等の人(物),匹敵する人(物)《+『of』+『名』》 / …のように / あたかも…のように
{名}(…に対する)『反応』《+『to』+『名』》 / 〈U〉(…に対する)(政治的・社会的な)『反動』,逆コース《+『against』+『名』》 / 〈U〉〈C〉化学反応,化学変化 / 〈U〉〈C〉(物理学で)反作用
〈U〉『病気でいること』;〈C〉(個々の)『病気』 / 〈U〉吐き気(nausea)
(…の)『好み』,趣味《+『for』(『to』)+『名』》
リンパ液 / 血清

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/22 00:02:37」(JST)

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[Wiki en表示]

Serum sickness-like reactions refer to adverse reactions that have similar symptoms to serum sickness, but in which immune complexes are not found.^[1]^:127

Pathogenesis

Serum sickness-like reaction is named for its clinical similarity to serum sickness, in which immune complexes are deposited in the skin, joints, and other organs. True serum sickness, a type III hypersensitivity reaction, results in fever, lymphadenopathy, arthralgias,cutaneous eruptions, gastrointestinal disturbances, proteinuria,and significant decreases in serum complement levels; it was originally described after patients were infused with equine immunoglobulins.

In contrast, serum sickness-like reactions are specific drug reactions that are not associated with circulating immune complexes.

Although the exact pathogenesis is poorly understood, serum sickness-like reactions are thought to originate from an abnormal inflammatory reaction that occurs in response to defective metabolism of drug byproducts generated during pharmacologic therapy; the metabolic flaw could be a maternally-inherited trait. In vivo hepatic drug biotransformation studies have shown greater lymphocyte killing in subjects with a known history of serum sickness-like reactions than in control subjects.

Diagnosis

The reaction generally includes a constellation of fever; urticarial polycyclic wheals (a rash that can look similar to hives with small swellings that overlap each other ^[2]) with central clearing on the trunk, extremities, face, and lateral borders of the hands and feet; oral edema without mucosal involvement; lymphadenopathy; arthralgias; myalgias; and mild proteinuria. 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.1,3-5 In contrast to true serum sickness, renal and hepatic involvement is rare. Significant decreases in serum C3, C4, and CH50, reported in the literature for true serum sickness, are rarely described in serum sickness-like reaction.

Causes

Agents that have been implicated in serum sickness-like reactions include cefaclor, amoxicillin, sulfonamides, tetracyclines,ciprofloxacin, nonsteroidal anti-inflammatory drugs, barbiturates, carbamazepine, propranolol, thiouracil, and allopurinol. Metabolites of these drugs might bind with tissue proteins inappropriately, eliciting an acute inflammatory response that typically develops 7–14 days after initiation of the offending agent. Acute hepatitis B will sometimes be complicated with this syndrome, often resolving as soon as the jaundice subsides.

Management

Serum sickness-like reaction is an acute self-limited reaction with an ultimately favorable outcome. Treatment is typically symptomatic, but hospitalization may be required for severe cases. While optimal treatment strategies for serum sickness-like reactions are not clearly defined in the literature, discontinuation of the suspected agent combined with use of antihistamines and corticosteroids for symptom control is an appropriate therapeutic route. Case reports have shown that treatment with prednisone, 60 mg daily, and high doses of H1 and H2 antihistamines help resolve the arthralgias and myalgias within 24 hours and the remaining symptoms within 48–72 hours

Notes

^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
^ http://www.nzdoctor.co.nz/in-print/2011/september-2011/7-september-2011/dermatology-update.aspx

References

Mener DJ, Negrini C, Blatt A: Itching like mad. American Journal of Medicine. 2009; 8(122): 732-734.

UpToDate Contents

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1. 血清病および血清病様反応 serum sickness and serum sickness like reactions
2. マクロライド系剤、アミノグリコシド、テトラサイクリン、クリンダマイシン、および
メトロニダゾールに対する過敏反応 hypersensitivity reactions to macrolides aminoglycosides tetracyclines clindamycin and metronidazole
3. 精漿に対するアレルギー反応 allergic reactions to seminal plasma
4. 環状皮膚病変が認められる患者に対するアプローチ approach to the patient with annular skin lesions
5. クロピドグレルへの過敏反応 hypersensitivity reactions to clopidogrel

English Journal

Serum sickness-like reaction in children due to cefditoren.

Misirlioglu ED, Duman H, Ozmen S, Bostanci I.SourceDepartment of Pediatric Allergy and Asthma, Dr. Sami Ulus Woman's Health and Children Education and Research Hospital, Ankara, Turkey.
Pediatric dermatology.Pediatr Dermatol.2012 May;29(3):327-8. doi: 10.1111/j.1525-1470.2011.01539.x. Epub 2011 Oct 20.
We describe the case of a 7-year-old boy with urticaria, fever, and arthritis that appeared 10 days after starting cefditoren therapy for acute tonsillopharyngitis, which was diagnosed as a serum sickness-like reaction due to this medication.© 2011 Wiley Periodicals, Inc.
PMID 22010630

Serum sickness-like reaction: histopathology and case report.

Tolpinrud WL, Bunick CG, King BA.SourceYale School of Medicine, Department of Dermatology, New Haven, CT 06520, USA.
Journal of the American Academy of Dermatology.J Am Acad Dermatol.2011 Sep;65(3):e83-5.
PMID 21839305