3133 Risk Factors for Systemic and Local Reactions to Subcutaneous Allergen Immunotherapy

Friday, 16 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Hikmet Tekin Nacaroglu, MD , Department of Allergy, Behcet Uz Children Hospital, Izmir, Turkey

Semiha Bahceci Erdem, MD , Pediatric Allergy and Immunology, Dr Behcet Uz Children's Hospital, Izmir, Turkey

Ozlem Sumer, MD , Pediatric Allergy and Immunology, Dr Behcet Uz Children's Hospital, Izmir, Turkey

Sait Karaman, MD , Pediatric Allergy and Immunology, Dr Behcet Uz Children's Hospital, Izmir, Turkey

Canan Sule Unsal Karkiner, MD , Pediatric Allergy and Immunology, Dr Behcet Uz Children's Hospital, Izmir, Turkey

Suna Asilsoy, MD , Division of Pediatric Allergy and Immunology, Dokuz Eylul University Hospital, Izmir, Turkey

Ilker Gunay, MD , Pediatric Allergy and Immunology, Dr Behcet Uz Children's Hospital, Izmir, Turkey

Demet Can, MD , Pediatric Allergy and Immunology, Dr Behcet Uz Children's Hospital, Izmir, Turkey

Background: Local, and especially systemic, reactions are important problems in subcutaneous immunotherapy (SCIT). Local reactions develop in 0.7-4% of all injections and systemic reaction develops in 0.2%. The current study aimed to evaluate the frequency and risk factors of reactions developing in patients undergoing SCIT.

Methods: Local and systemic reactions developing after 14,308 injections between 2003 and 2013 were retrospectively evaluated in the current study. The grading system for systemic reactions that was recommended by the World Allergy Organization (WAO) was used. The type of allergic disease, the allergens producing sensitivity, the vaccine content, the adjuvant content, and the effects of treatment phase on frequency of adverse effects were investigated.

Results: Out of 329 patients included, there was local reaction in 11.9%, large local reaction in 6% and systemic reaction in 4.7%; local reactions were observed in 0.38% of all injections, whereas a systemic reaction was observed in 0.1% of all injections. Local reactions were frequent at the initial phase and systemic reactions were frequent at the maintenance phase (p=0.01). Adverse reactions were more common in patients vaccinated (SCIT) with multiple allergens and house-dust-mites (p=0.002) (p=0.001). No statistically significant difference was found between the content of the adjuvant and the frequency of adverse effects (p=0.319). 

Conclusion: The frequency of local and wide local reactions during subcutaneous immunotherapy were lower than expected. Although systemic reactions are frequently seen, no fatal reaction was observed in the current study. Mite immunotherapy and multiple allergen use increase the risk of reaction.