Immediate adverse reactions to subcutaneous allergen specific immunotherapy in respiratory allergies

Objective: Allergen immunotherapy has been used in the management of allergic diseases for nearly a hundred years; however, its short term side-effects can effect the decision of starting the therapy. Material and Methods: This study is a retrospective evaluation of the immediate local and systemic reactions seen in the cases who were given immunotherapy between March 1997 and September 2008 in the Ege University Faculty of Medicine, Department of Pediatric Allergy and Pulmonology. Results: The 541 patients had ages ranging from 6 to 18 years. 64.3% (n=348) of the patients were having calcium phosphate-adsorbed allergen vaccines, while35.7% (n=193)were having aluminium hydroxide adsorbed vaccines. Of the patients, 229 patients had allergic rhinitis (42.3%), 161 had asthma (29.7%), and 151 had both asthma and allergic rhinitis(27.9%). Totally, 28.374 injections were given to the patients. In 4.6% (n=1310) of the injections immediate reactions were detected; 74% (n=970) of them were observed during the build-up therapy (p<0.01), and 81.6% (n=1069) of the reactions were detected in the patients who were receiving calcium phosphate-adsorbed vaccines (p< 0.01). There was no statistically significant difference in the immediate reaction rates of the subjects when comparing the allergens in the vaccines or the diagnosis of the patients. The frequency of systemic reactions was 0.04% (n 13); most of these reactions were detected during the build-up therapy and in patients with asthma + allergic rhinitis. With early term interventions, the symptoms of all patients improved in a short time. Conclusion: In conclusion, most of the immediate reactions to immunotherapy are local and the systemic ones are controllable through early treatment; so that subcutaneous immunotherapy is a safe treatment modality when it is used for appropriate indications by experienced staff. Copyright © 2010 by Türkiye Klinikleri