zur Navigation zum Inhalt
Innere Medizin 1. Juni 2009

The local and systemic side-effects of venom and inhaled-allergen subcutaneous immunotherapy

BACKGROUND: Although immunotherapy is effective in allergic rhinitis, conjunctivitis, asthma and stinging insect hypersensitivity, it carries a risk of anaphylactic reactions. METHODS: In a 4-year retrospective survey, we investigated 1257 adult patients who had received venom or inhaled-allergen subcutaneous immunotherapy. The dose-increase phase was performed as the 2-day rush protocol for venom immunotherapy and the 6-week protocol for inhaled-allergen immunotherapy. RESULTS: A total of 904 patients received venom immunotherapy and 353 patients inhaled-allergen immunotherapy. The prevalence of systemic reactions was 13.6%. The frequency of systemic reactions was higher during the maintenance phase than in the dose-increase phase (9.6% vs. 5.9%) and was highest in both phases of treatment with honeybee venom (P < 0.001). The majority of systemic reactions were mild. Five (0.4%) patients had reaction with a fall of blood pressure and were treated with adrenaline. There was no fatal outcome. The systemic side-effects during the dose-increase phase of venom immunotherapy occurred at a median dose of 46 μg (range 2–100 μg). Large local reactions occurred in 13.9% of patients without any significant difference between the allergens. CONCLUSIONS: We have shown that systemic reactions are not rare even during maintenance phase in patients with a well tolerated dose-increase phase of treatment. The most prominent risk factor for systemic reactions was immunotherapy with honeybee extract.

Katja Adamic, Mihaela Zidarn, Nissera Bajrovic, Renato Erzen, Peter Kopac, Ema Music, Wiener klinische Wochenschrift 9/10/2009

Volltext dieses Beitrags / entire article auf SpringerLink

Zu diesem Thema wurden noch keine Kommentare abgegeben.

Mehr zum Thema

<< Seite 1 >>

Medizin heute

Aktuelle Printausgaben