Dupilumab-induced serum sickness-like reaction in a pediatric patient

Dupilumab is a human monoclonal IgG4 antibody targeted against interleukins 4 and 13. It has been approved for atopic dermatitis (AD) since 2017, and in June 2022 dupilumab’s indication expanded to include patients of 6 months to 5 years of age.1 Dupilumab is generally well tolerated but there have been 4 case or clinical trial reports of classic serum sickness (CSS) or serum sickness-like reaction (SSLR) in adults.2-4 CSS is a systemic type III hypersensitivity reaction to foreign proteins in antitoxins, monoclonal antibodies, or antigenic vaccination resulting in immune complex depositions into synovial joints and parenchymal tissue.