Nonorganic adverse reactions to aeroallergen immunotherapy

Ten patients are presented who exhibited adverse reactions to immunotherapy (IT) which mimicked immunologically mediated reactions but were thought to be nonorganic in etiology. The nonorganic nature of the reactions was considered to be established in 6 of these patients and highly likely in the remaining 4. These reactions tended to occur in young patients, particularly women, at relatively low allergen extract doses and were associated with minimal or no objective findings. There was a high incidence of coexisting or contributory psychiatric problems in these patients, particularly involving hysterical or hypochondriacal personality traits. In some patients presenting with nonorganic adverse reactions to immunotherapy, it appears that the immunotherapy may be successfully continued after the patient gains insight into the nature of the reactions. In other patients, however, these reactions may necessitate discontinuing immunotherapy, and in still other patients, these reactions may confirm the need for psychiatric consultations.