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[A localized reaction to sublingual immunotherapy].
A L H J Aarnoudse1, H van den Berge, A M H Bijl
1Inspectie voor de Gezondheidszorg, 2500 BC Den Haag.
Nederlands Tijdschrift Voor Geneeskunde
|August 12, 2006
Summary
Sublingual allergen immunotherapy for grass pollen allergy can cause significant localized swelling. Alternative subcutaneous immunotherapy proved effective and safe, highlighting the need for caution with oral allergen treatments.
Area of Science:
- Allergy and Immunology
- Pharmacovigilance
Background:
- Allergen-specific immunotherapy (ASIT) aims to desensitize patients to allergens.
- Sublingual ASIT (SLIT) is a common, non-invasive administration route.
- Clinical trials for SLIT often report a lack of serious adverse events.
Observation:
- A 31-year-old woman experienced severe floor of mouth swelling after SLIT for grass pollen allergy.
- Symptoms resolved upon discontinuation of SLIT.
- The patient was successfully treated with subcutaneous immunotherapy (SCIT).
Findings:
- The Netherlands Pharmacovigilance Centre Lareb received multiple reports of localized reactions to oral and sublingual ASIT.
- These reactions can be severe, despite under-reporting due to expectation of local side effects.
Implications:
- Caution is warranted with allergen immunotherapy, including non-invasive routes like SLIT.
- Healthcare providers should be vigilant for and report localized adverse reactions to ASIT.
- SCIT may be a safer alternative for patients experiencing significant local reactions to SLIT.