1010 AAAAI Membership Experience with Venom Immunotherapy in Chronic Medical Conditions, Pregnancy and Young Children

Friday, 13 December 2013
Michigan Ballroom (Westin - Michigan Avenue)

Christopher Calabria, MD, FAAAAI , Dilley Allergy and Asthma, Helotes, TX

David Hauswirth, MD, FAAAAI , The Ohio State University, The Ohio State University Medical Center, Columbus, OH

Matthew Rank, MD, FAAAAI , Mayo Clinic, Rochester, MN

Lawrence Sher, MD, FAAAAI , Peninsula Research Associates, Rolling Hills Estates, CA

Désirée Larenas-Linnemann, MD, FAAAAI, Dist. Intl FACAAI , Hospital Médica Sur, Mexico City, Mexico

Background: Little data exists regarding use of VIT in specific high-risk chronic medical conditions, pregnancy and young children.

Methods: A web-based survey (Surveymonkey®) was sent to AAAAI members to explore their VIT experience in high-risk medical conditions, pregnancy, and young children.  Major problems were defined as “activation of underlying disease and/or AIT not well tolerated (systemic adverse events) and/or AIT discontinued for medical reasons”.  Results were expressed descriptively.

Results:  697 of 5123(14%) surveys were completed.  87% of respondents were US-based, with 28% working in an academic setting.  Most respondents (71%) felt pregnancy was a contraindication for starting VIT.  Most felt comfortable continuing VIT (51%) if the woman became pregnant after starting.  Of Allergists treating children, most would give VIT down to age 5 (42%) or younger (35% ages 1-4).

The following data represent the number of Allergists utilizing VIT in patients with this condition and the (%) that reported major problems:  severe asthma:  212(4.2%); hypertension 287(1.1%); coronary artery disease 222(3.6%); arrhythmias 136(3.4%); cerebro-vascular disease 104 (5.1%); cancer, in remission 166 (0%); cancer, stable, but still under treatment 44(7.2%); history of bone marrow transplantation 15(4.9%); history of solid organ transplantation 29(3.6%); HIV 53(1.4%); AIDS 24(6.2%); stable autoimmune disease 164(2.8%); mastocytosis 66(18.4%); elevated serum tryptase 101(10.8%); immunodeficiency 59(2.5%).

Conclusions:   Many Allergists felt comfortable using VIT in young children and continuing but not starting pregnant women on VIT.  VIT was commonly utilized in patients with hypertension, coronary artery disease, arrhythmias, cancer in remission and stable autoimmune disease.  Major problems were most frequently reported in use with mastocytosis, elevated tryptase, and cancer still under treatment.