[Case of pollinosis to grass pollens who presented with dyspnea successfully treated by rush immunotherapy]

We present a 15 years old boy who experienced unusual symptoms for pollen allergy, and successfully treated by rush immunotherapy. The patient started to complain erythema and edema on his face and serous rhinorrhea at 10 years old when going out. He entered baseball team at junior high school, and subsequently experienced choking sensation, dyspnea, face edema, and it was sometimes impossible to continue play. He was diagnosed as bronchial asthma at some hospital, and prescribed many anti-asthma medications including inhaled corticosteroid, which did not take effect. His symptoms deteriorated in summer and ameliorated in winter. When he was 15 years old, he was referred to us by a pediatrician for reassessment of his symptoms. Flow-volume curve was normal, and bronchial provocation test (acetylcholine and histamine), and exercise challenge were negative. IgE antibodies specific to grass pollens were highly positive. We made a diagnosis of pollinosis to grass pollens instead of bronchial asthma. Oral antihistamines and intranasal corticosteroid partially improved his symptoms. We started rush-immunotherapy of grass-pollens (oats and bromegrass), Japanese cedar, and ragweed. His symptoms improved dramatically on the next season of grass pollens.