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Safety of sublingual grass pollen immunotherapy after anaphylaxis

Published online by Cambridge University Press:  23 May 2008

J R Nichani  and
J de Carpentier
J R Nichani*
Affiliation:
Department of Otolaryngology, Lancashire Teaching Hospitals NHS Trust, Preston, UK
J de Carpentier
Affiliation:
Department of Otolaryngology, Lancashire Teaching Hospitals NHS Trust, Preston, UK
*
Address for correspondence: Mrs J R Nichani, 14 Uplands Chase, Fulwood, Preston PR2 7AW, UK. Fax: 01772 523233 E-mail: jayanichani@hotmail.com
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Abstract

Aim:

To demonstrate that sublingual immunotherapy is a safe treatment option in patients who have previously suffered anaphylaxis when undergoing subcutaneous grass pollen immunotherapy.

Case report:

We report two patients who developed a systemic anaphylactic reaction following subcutaneous grass pollen immunotherapy, resulting in discontinuation of treatment. Following treatment of the acute anaphylactic episode, both patients were subsequently safely commenced on sublingual grass pollen immunotherapy.

Conclusion:

Injection immunotherapy has a relatively low risk of severe adverse events, although anaphylaxis is a potentially fatal complication and usually results in termination of the immunotherapy programme. Sublingual immunotherapy has a safer side effect profile than subcutaneous immunotherapy, with no reported cases of anaphylaxis.

Keywords

Seasonal Allergic RhinitisImmunotherapyAnaphylaxis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 6 , June 2009 , pp. 683 - 684
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Bousquet, J, van Cauwenberge, P, Khaltaev, N. Allergic rhinitis and its impact on asthma (ARIA). The World Health Organization Initiative. J Allergy Clin Immunol 2001;108(suppl 5):S147–334CrossRefGoogle Scholar
2 Varney, VA, Gaga, M, Frew, AJ, Aber, VR, Kay, AB, Durham, SR. Usefulness of immunotherapy in subjects with severe summer hay fever uncontrolled by antiallergic drugs. BMJ 1991;302:265–9CrossRefGoogle Scholar
3 Walker, SM, Varney, VA, Gaga, M, Jacobson, MR, Durham, SR. Grass pollen immunotherapy: efficacy and safety during a 4-year follow-up study. Allergy 1995;50:405–13CrossRefGoogle ScholarPubMed
4 Dolz, I, Martinez-Cocera, C, Bartolome, JM, Cimarra, M. A double-blind, placebo-controlled study of immunotherapy with grass-pollen extract during a 3 year period with initial rush immunotherapy. Allergy 1996;51:489–500Google ScholarPubMed
5 Durham, SR, Walker, SM, Varga, EM, Jacobson, MR, O'Brien, F, Noble, W et al. Long-term clinical efficacy of grass-pollen immunotherapy. N Engl J Med 1999;341:468–75CrossRefGoogle ScholarPubMed
6 Lockey, RF, Nicoara-Kasti, GL, Theodoropoulos, DS, Bukantz, SC. Systemic reactions and fatalities associated with allergen immunotherapy. Ann Allergy Asthma Immunol 2001;87(suppl 1):47–55CrossRefGoogle ScholarPubMed
7 Tinkleman, DG, Cole, WQ, Tunno, J. Immunotherapy: a one year prospective study to evaluate risk factors of systemic reactions. J Allergy Clin Immunol 1995;95:8–14CrossRefGoogle Scholar
8 Ostergaard, PA, Kaad, PH, Kristensen, T. A prospective study on the safety of immunotherapy in children with severe asthma. Allergy 1986;41:567–78CrossRefGoogle ScholarPubMed
9 Bauchau, V, Durham, SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J 2004;24:758–64CrossRefGoogle ScholarPubMed
10 Bosquet, J, Lockey, R, Malling, HJ. WHO position paper. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Allergy 1998;53(suppl 44):1–42Google Scholar
11 Committee on safety of medicines. Desensitising vaccines. BMJ 1986;293:948CrossRefGoogle Scholar
12 Wilson, DR, Torres, LI, Durham, SR. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2003;(2):CD002893CrossRefGoogle ScholarPubMed
13 Kleine-Tebbe, J, Ribel, M, Herold, DA. Safety of a SQ-standardised grass allergen tablet for sublingual immunotherapy: a randomized, placebo-controlled trial. Allergy 2006:61:181–4CrossRefGoogle ScholarPubMed
14 Dahl, R, Kapp, A, Colombo, G, de Monchy, J, Rak, S, Emminger, W et al. Efficacy and safety of sublingual immunotherapy with grass allergen tablets for seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006;118:434–40CrossRefGoogle ScholarPubMed