Nebenwirkungen der subkutanen spezifischen Immuntherapie. Ergebnisse einer Praxisanalyse von 1993 – 2007

Abstract

Subcutaneous specific immunotherapy is the most important form of therapy for IgE-mediated diseases. However, a danger for local or systemic side effects is present for all allergens used. The mostly harmless local reactions are classified by size. Systemic reactions are classified according to their severity, ranging from e.g. urticaria and flush to severe reactions (bronchospasms, pre-shock, shock) to the point of vital organ failure. While mild systemic reactions occurred in all treatment groups, pronounced systemic reactions were mainly seen in patients with an allergy against bee venom or house dust mite; life-threatening reactions occurred almost exclusively in patients with bee venom allergy. Due to the increased risk of patients with a history of bronchial asthma, a non-specific bronchial provocation test should be carried out in these cases in order to determine the bronchial reactivity and to increase safety. Insufficient anamnestic investigation before each injection is mainly considered to be the reason for the occurrence of side effects despite an adequate indication. Further clinical studies have to be carried out in order to evaluate if a sublingual treatment is equally effective and can improve the safety of specific immunotherapy and thus reduce the risk of severe side effects.