Fatalities following allergen immunotherapy

Area of Science:

• Immunology
• Allergy and Clinical Immunology

Background:

• Allergen immunotherapy (AIT) is a long-standing treatment for allergic conditions like allergic rhinitis, asthma, and insect venom hypersensitivity.
• Despite its benefits, AIT is associated with severe adverse reactions, including anaphylaxis and fatalities.
• The incidence of severe reactions has risen with the use of standardized and potent allergen extracts.

Purpose of the Study:

• To review and identify critical risk factors associated with severe anaphylactic reactions during allergen immunotherapy.
• To provide insights into mitigating these risks and enhancing patient safety.

Main Methods:

• This is a review article, synthesizing existing knowledge on AIT risks.
• The review focuses on analyzing documented risk factors contributing to anaphylaxis.

Main Results:

• Several risk factors are identified, including dosage errors, incorrect extract administration, intravenous injection, failure to postpone treatment during illness or exacerbations, inadequate post-injection observation, and non-adherence to contraindications.
• Concurrent use of beta-adrenergic blockers, use of allergen mixtures, administration during peak allergy season, and specific allergen types are also highlighted as risk factors.

Conclusions:

• Understanding and addressing these identified risk factors is crucial for minimizing the incidence of anaphylaxis in patients undergoing allergen immunotherapy.
• Adherence to established guidelines and careful patient monitoring are essential for safe AIT practice.