Skip Navigation LinksHome > August 2014 - Volume 14 - Issue 4 > Anaphylaxis: still a ghost behind allergen immunotherapy
Current Opinion in Allergy & Clinical Immunology:
doi: 10.1097/ACI.0000000000000075
ANAPHYLAXIS AND INSECT ALLERGY: Edited by Jeffrey G. Demain and Gianenrico Senna

Anaphylaxis: still a ghost behind allergen immunotherapy

Makatsori, Melina; Calderon, Moises A.

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Purpose of review: Allergen immunotherapy has been shown to be an effective treatment for respiratory allergies and Hymenoptera venom allergy. However, concern regarding its potential to cause anaphylaxis may limit its use. This review aims to assess whether anaphylaxis is still a worry when administering subcutaneous (SCIT) and sublingual immunotherapy (SLIT).

Recent findings: Retrospective surveillance surveys and one ongoing North American prospective study have helped to characterize the incidence and risk factors for fatal and nonfatal systemic reactions to SCIT. The latest rate of very severe, World Allergy Organization grade 4, systemic reactions was similar to the previously reported rates of near-fatal reactions, that is, 1 in 1 million injections. Regarding SLIT, no fatalities have been reported. Case reports of anaphylaxis in clinical practice and in some clinical trials have been described; however, given the number of doses administered daily throughout the world, the number is very small.

Summary: Identification of possible risk factors and the introduction of safety guidelines and practice parameters have enabled the reduction in immunotherapy related systemic reactions. However, it is important that clinicians remain vigilant when administering immunotherapy and should be prepared to provide emergency treatment if required.

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.


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