J Otolaryngol Ophthalmol Shandong Univ ›› 2018, Vol. 32 ›› Issue (5): 71-74.doi: 10.6040/j.issn.1673-3770.0.2018.158

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Factors associated with systemic adverse reactions after subcutaneous immunotherapy injections and treatment options

WANG Tan, WU Ke, LI Lianqing, GONG Lili   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Liaocheng Peoples Hospital, Liaocheng 252000, Shandong, China
  • Received:2018-03-26 Online:2018-09-20 Published:2018-09-20

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Abstract: Objective To analyze the factors associated with and the treatment of systemic adverse reactions after subcutaneous immunotherapy(SCIT)injections. Methods We retrospectively analyzed the records of patients with systemic anaphylaxis who presented to the Allergic Diseases Outpatient Department between January 2013 and December 2017. Results A total of 4597 SCIT injections had been administered to 191 patients, and 23 cases/instances of systemic adverse reactions were reported in 21 patients. The incidence of systemic adverse reactions was 0.5%. An immediate reaction was observed in 17 and a delayed reaction was observed in 6 cases. Systemic adverse reactions occurred during the initial treatment in 6 and during maintenance treatment in 17 cases. Based on the World Allergy Organization immunotherapy guidelines, 7 cases were classified as grade 1, 15 as grade 2, 1 as grade 3, 0 as grade 4, and 0 as grade 5. After exclusion of the associated factors, continuing to inject the original dose showed no adverse reactions. Conclusion Systemic reactions usually occur during the dose maintenance period. Alcohol intake, infections, ingestion or inhalation of a large number of allergens, hot water baths, exercise, fatigue, emotional stress, fasting, early pregnancy, and a few specific immunoglobulin E-mediated diseases are known risk factors for systemic adverse reactions in patients who receive multiple injections and tend to develop tolerance to the dose. Detailed questioning regarding the patients recent life history prior to each injection and careful assessment of the injector are important to reduce systemic allergic reactions. Continuing to inject the original dose after excluding the contributory factors is safe.

Key words: Allergic rhinitis, Subcutaneous immunotherapy, Systemic adverse reactions, Factors

CLC Number: 

  • R765.4
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