Systemic Reactions to Dust Mite Subcutaneous Immunotherapy: A 3-Year Follow-up Study

• Published in: Allergy, asthma & immunology research Vol. 8; no. 5; pp. 421 - 427
• Main Authors: Dong, Xiang, Huang, Nan, Li, Wenjing, Hu, Lintao, Wang, Xiaolong, Wang, Yin, Xiang, Ning, Liu, Guanghui, Zhu, Rongfei
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease 01.09.2016; 대한천식알레르기학회
• Subjects: Dermatophagoides; Original; 내과학; Subcutaneous immunotherapy; risk factors; Dermatophagoides pteronyssinus; systemic reactions
• ISSN: 2092-7355; 2092-7363
• DOI: 10.4168/aair.2016.8.5.421

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. 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. 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). 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.