Local and Systemic Reactions in Allergen Specific Immunotherapy

Aim: Local or fatal systemic reactions can be seen in allergen specific immunotherapy. This study was designed to investigate the possible reactions in subcutaneous conventional allergen specific immunotherapy in childhood. Materials and Methods: Subjects receiving immunotherapy for house dust mite-mix (D.Pteronyssinus 50%, D.Farinae 50%) or grasses-cereals pollens mix (Grasses pollens 55%, Hordeum vulgare 10%, Avena sativa 10%, Secale cereale 15%, Triticum sativum 10%) in Uludag University Medical Faculty, Pediatric Allergy Department from 1999 to 2007 were randomly recruited and retrospectively investigated. Local reactions were defined as edema and/or erythema of 2 to 5 cm at injection site, and edema and/or erythema greater than 5 cm were defined as large-local reactions. Systemic reactions were defined as the presence of at least one of the followings: urticaria, angioedema, bronchospasm, laringospasm and severe anaphylaxis. Results: During the study period, a total of 7110 injections were administered to 132 patients having asthma (n=85), allergic rhinitis or allergic rhinoconjunctivitis (n=22) and asthma with allergic rhinitis or allergic rhinoconjunctivitis (n=25). Sixty-eight patients had immunotherapy for mite-mix and 64 for grasses-cereals mix. Local reactions were detected in 35 patients (26,5%) after 412/7110 injections (5.8%) and large-local reactions in 13 (9.8%) patients after 41 injections (0.6%). Systemic reactions were detected in 21 (15,9%) patients, after 32 injections (0,4%). Conclusion: During the subcutaneous allergen specific immunotherapy in pediatric population side effects such as local, large-local and systemic reactions may occur to some extent. So, immunotherapy must be started, administered and followed- up only in specialized centers by specialized persons in optimal conditions where emergency intervention facilities are available.