Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature Review

Table 1

Monoclonal and polyclonal antibody-associated serum sickness and acute kidney injury case reports and treatment modalities.

Author	Patient Characteristics	Antibodies Used (ATG, ATGAM, or Rituximab)	Indication of Antibodies	Treatment Used	Cause of AKI and Methods	Specific treatment for AKI if Any
Snow et al. [6]	48-year-old female with CRT	Rabbit-ATG	Induction	Prednisone 60 mg PO/day for 2 days	Unknown	Conservative
Pham et al. [7]	Female with LRT	Rabbit-ATG	Acute Cellular Rejection	TPE × 2 treatments	Unknown	Conservative
	32-year-old male with CRT	Rabbit-ATG	Induction or Acute Cellular Rejection	1 mg/kg/day oral Prednisone or 2 mg/kg/day for 2 days Followed by TPE × 1-2 treatments	Unknown	Conservative
	60-year-old male with CRT	ATGAM	Induction or Acute Cellular Rejection	As Above	Unknown	Conservative
Tanriover et al. [4]	31-year-old male with CRT	Rabbit-ATG	Induction or Acute Cellular Rejection	As Above	N/A	N/A
	41-year-old male with LT	Rabbit-ATG	Induction or Acute Cellular Rejection	As Above	Unknown	Conservative
	39-year-old Female with CRT	Rabbit-ATG	Induction or Acute Cellular Rejection	As Above	N/A	N/A
Da Silva et al. [8]	10-year-old female with aplastic anemia	Rabbit-ATG	Aplastic Anemia	30 mg/kg/day of Methylprednisone for 3 days followed by prednisone taper	Unknown	Peritoneal Dialysis for 14 days
Boothpur et al. [9]	24-year-old female with LURT	Rabbit-ATG	Induction	TPE and Methylprednisone 500 mg IV for 2 doses	N/A	N/A
	20-year-old female with LURT	Rabbit-ATG	Induction	TPE × 3 treatments	N/A	N/A
	37-year-old male LURT	Rabbit-ATG	Induction	TPE × 2 treatments	N/A	N/A
	51-year-old male with LRT	Rabbit-ATG	Induction	Methylprednisone 500 mg IV × unknown doses followed by prednisone taper	N/A	N/A
Andresdottir et al. [10]	51-year-old male with kidney transplant	Horse-ATG	Induction	Unknown	Endocapillary Glomerulonephritis on Kidney biopsy	Conservative
Lundquist et al. [11]	45-year-old female with Liver Transplant	Rabbit-ATG	Induction	Methylprednisone 250 mg (3 mg/kg/day) × 3 doses	Unknown	Conservative
Disperati et al. [12]	52-year-old female with follicular lymphoma	Rituximab	Stage IV Follicular Lymphoma	IV Methylprednisone of unknown dose	N/A	N/A
DeMonaco and Jacobs [13]	47-year-old female with follicular lymphoma	Rituximab	Follicular Lymphoma	High dose corticosteroids followed by 10-day prednisone taper that failed. Then unknown doses of prednisone and indomethacin	N/A	N/A
D’Arcy and Mannik [14]	45-year-old male with refractory autoimmune polyneuropathy	Rituximab	Refractory Autoimmune Polyneuropathy	Pulse corticosteroids of unknown doses	N/A	N/A
Herishanu [15]	48-year-old female with refractory immune thrombocytopenia	Rituximab	Refractory Immune Thrombocytopenia	Methylprednisone 500 mg IV × 2 days	N/A	N/A
Hellerstedt and Ahmed [16]	23-year-old female with Lupus	Rituximab	Autoimmune Thrombocytopenia	Steroid bolus of unknown doses	N/A	N/A
Todd and Helfgott [1]	68-year-old male with stage 2A mantle cell lymphoma	Rituximab	Treatment for Mantle Cell Lymphoma	Intra-articular Methylprednisone 80 mg and Oral prednisone 20 mg daily followed by Prednisone taper for 4 weeks	N/A	N/A
Sandhu et al.	51-year-old male with CRT	Rabbit-ATG and Rituximab	Acute Cellular Rejection	SoluMedrol 500 mg IV × 3 days	Acute Tubular Necrosis findings on Urine Microscopy	Conservative

*ATG: antithymocyte globulin; ATGAM: antithymocyte globulin or lymphocyte immune globulin; TPE: therapeutic plasma exchange; CRT: cadaveric renal transplant; LRT: living-related transplant; LURT: living-unrelated transplant; IV: intravenous.