Allergy Asthma Respir Dis.  2017 Nov;5(6):336-343. 10.4168/aard.2017.5.6.336.

Safety of ultrarush allergen subcutaneous immunotherapy in children with allergic disease

• Cho SW
• Lee GM
• Park JS
• Kwon JW
• Kim JK

• KMID: 2396675
• DOI: http://doi.org/10.4168/aard.2017.5.6.336

Abstract

PURPOSE
Ultrarush immunotherapy (ultra-RIT) is more convenient and higher compliant than conventional immunotherapy, but it has rarely used in clinical practice due to severe systemic reactions. This study aimed to determine the safety of ultra-RIT in children and adolescents.
METHODS
We investigated 19 patients who received ultra-RIT with the same schedule between January 2011 and May 2016. They were sensitized to house dust mites (HDMs) and/or pollen and had their symptoms associated with positive allergens. Over a 1-day hospitalization period, all patients received ultra-RIT subcutaneously 3 times, increasing at hourly intervals. Systemic reactions were classified according to the World Allergy Organization grade system.
RESULTS
Systemic reactions occurred in 14 patients (73.7%). The mean time to adverse reactions after the last injection was 36 minutes, and the majority of systemic reactions were pruritus and urticaria. In addition, the injection of HDM alone or HDM plus pollen caused more than grade 2 systemic reactions in about 50% each of the patients.
CONCLUSION
Since ultra-RIT caused a higher incidence of systemic reactions in children and adolescents, it should be carried out cautiously in the hospitalization rather than the office.

Keyword

Immunotherapy; Subcutaneous injections; Allergen; Safety; Pediatrics

MeSH Terms

Adolescent
Allergens
Appointments and Schedules
Child*
Hospitalization
Humans
Hypersensitivity
Immunotherapy*
Incidence
Injections, Subcutaneous
Pediatrics
Pollen
Pruritus
Pyroglyphidae
Urticaria
Allergens

Figure

• 

  Fig. 1 Protocol for ultrarush immunotherapy. Novo-Helisen Depot (Allergopharma Joachim Ganzer KG, Reinbeck, Germany) with allergen concentration 5,000 units/mL was injected 3 times at 1-hour interval for 3 hours subcutaneously.10 Third injected dose was 50% maximal allergen dose. Maintenance treatment was started at 2 weeks after rapid induction. Antihistamine was taken 1 week prior to immunotherapy and two more weeks before the next visit. BP, blood pressure; HR, heart rate; RR, respiratory rate.

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