Systemic Reactions to Dust Mite Subcutaneous Immunotherapy: A 3-Year Follow-up Study.
10.4168/aair.2016.8.5.421
- Author:
Xiang DONG
1
;
Nan HUANG
;
Wenjing LI
;
Lintao HU
;
Xiaolong WANG
;
Yin WANG
;
Ning XIANG
;
Guanghui LIU
;
Rongfei ZHU
Author Information
1. Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. zrf13092@163.com
- Publication Type:Original Article
- Keywords:
Subcutaneous immunotherapy;
systemic reactions;
Dermatophagoides pteronyssinus;
risk factors
- MeSH:
Asthma;
Child;
China;
Demography;
Dermatophagoides pteronyssinus;
Diagnosis;
Dust*;
Follow-Up Studies*;
Humans;
Immunotherapy*;
Incidence;
Mites*;
Respiratory Function Tests;
Risk Factors
- From:Allergy, Asthma & Immunology Research
2016;8(5):421-427
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The incidence of allergen specific immunotherapy-related systemic reactions (SRs) varies among different studies, and many factors are likely to contribute to SRs. This study aims to investigate the incidence, characteristics, and risk factors of SRs to standardize dust mite-specific subcutaneous immunotherapy (SCIT) in Central China. METHODS: All patients receiving standardized dust mites (100-100,000 SQ-U/mL; Alutard SQ, Hørsholn, Denmark) immunotherapy were followed up. Recorded data included demographics, diagnosis, patient status, pulmonary function testing results before and after each injection, allergen dosage, and details of SRs. RESULTS: From June 2011 to August 2014, a total of 208 patients received 4,369 injections; 27 (13.0%) patients experienced 48 (1.1%) systemic reactions. Most of the SRs were grade 2 reactions (n=30, 62.5%), followed by grade 1 (n=11, 22.9%), grade 3 (n=7, 14.6%), and no fatal reactions occurred. Forty-six SRs (95.8%) occurred within 30 minutes. Higher SR rates were associated with high concentration extracts (100,000 SQ-U/mL), injections with concomitant local reactions (LRs), children, asthma and high sensitivity (skin prick test 3+/4+ and/or sIgE≥17.5 kUA/L) (P<0.05). The estimated odds of SRs increased in children (OR=6.57; 95% CI: 1.88-22.97, P=0.003), asthmatic patients (OR=4.10; 95% CI: 1.72-9.80, P=0.002), and injections with LRs (OR=2.41; 95% CI: 1.33-4.36, P=0.004). CONCLUSIONS: The incidence of SRs to dust mite SCIT was low, and multiple factors were associated with the increased incidence of SRs. Children, asthmatics and patients with concomitant LR may be prone to develop SRs.
