The frequency of large local and systemic reactions after subcutaneous immunotherapy in children

Objective: Although subcutaneous allergen immunotherapy is effective in treating allergic rhinitis and asthma and in preventing stinging insect anaphylaxis, it carries risk of local and systemic reactions. The purpose of this study was to determine the frequency of adverse reactions of subcutaneous allergen immunotherapy in children. Materials and Methods: A retrospective data were examined from pediatric patients who received pollen or venom allergen subcutaneous allergen immunotherapy. Standard allergen extracts were used for immunotherapy. The severity of the systemic reactions was graded according to criteria of the World Allergy Organization. A large local reaction was defined as a local swelling greater than the size of the patient's palm at the site of allergen injection. Results: A total of 960 injections were administered to 47 patients. Twenty seven and 20 out of 47 patients received pollen and venom immunotherapy respectively. Three systemic reactions were observed in only one patient. The frequency of systemic reactions was 0.3%. Fifteen (31.9%) patients developed a total of 31 large local reactions which correspond to 3.2% of the administered doses. Conclusion: Although subcutaneous allergen immunotherapy is a safe treatment modality of allergic diseases; it must be administrated only in centers that have appropriate emergency equipments because of side effects.