[Indications and evidence base for specific immunotherapy in childhood]

Allergic rhinitis (AR) is a common disease affecting 7-17% of children and adolescents who may suffer from a significantly impaired quality of life. For 100 years subcutaneous immunotherapy (SCIT) has been used to treat AR. If patients are chosen carefully, a clinically relevant reduction of seasonal symptoms and medication use can be achieved by SCIT. Serious adverse events are rarely encountered during adequately performed and monitored SCIT. Sublingual immunotherapy (SLIT) may be used as a less painful therapeutic alternative in children if the administration of SCIT is impossible. Recent controlled trials have shown that SLIT performed over one pollen season also ameliorates seasonal symptoms and reduces the need for concomitant medication. Local reactions are frequently encountered during SLIT whereas systemic and life-threatening adverse events under correctly performed SLIT have not been reported so far.