Subcutaneous venom immunotherapy in children

Publication date: April 2018
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 4
Author(s): Pınar Gür Çetinkaya, Saliha Esenboğa, Özge Uysal Soyer, Ayfer Tuncer, Bülent Enis Şekerel, Ümit Murat Şahiner
BackgroundVenom immunotherapy (VIT) is safe in children, although adverse effects can occur.ObjectiveTo document adverse effects and to determine re-sting reactions and the efficacy of VIT in childhood.MethodsWe retrospectively analyzed data from children who had taken VIT from 2002 through 2015. These patients were queried by telephone to determine reactions after re-stings during or after VIT.ResultsIn total 107 children with a systemic reaction after Hymenoptera sting and with proved immunoglobulin E-mediated sensitization were enrolled. Participants had a median age of 10.0 years (7.2–12.4 years) at the beginning of immunotherapy. Fifty-two participants had allergic reactions during VIT; 40 of these reactions were local (37.4%), 5 were large local (4.7%), and 7 were systemic (6.5%). Of the 52 patients with adverse reactions, most reactions were local (n = 40, 89%) and were observed mainly in dose-increase periods (n = 25, 60%; P < .001). Although local reactions were more frequently seen with Vespula treatment (P = .047), systemic reactions were common with Apis treatment (P = .031). Sixty-eight patients (63.5%) were queried for re-sting, 33 (48.5%) had a re-sting and 24 (72.7%) of these 33 patients developed allergic reactions. The reactions were local (n = 19), large local (n = 1), and systemic (n = 4). Risk analysis for local and systemic reactions during VIT showed pre-existing asthma as an independent risk factor (odds ratio 4.1, 95% confidence interval 1.3–12.7, P = .016).ConclusionIn children, VIT appears to be safe and protective against severe reactions after re-sting. However, pre-existing asthma was identified as a risk factor for systemic and large local reactions during VIT in children.



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