Safety and efficacy of the ultra-rush immunotherapy with extracts of Dermatophagoides pteronyssinus in children / 소아과

ABSTRACT

PURPOSE: Immunotherapy is accepted as the only treatment of allergic disease that can modify the natural course of the disease and ameliorate symptoms. This study aimed to evaluate the safety and efficacy of ultra-rush therapy using Dermatophagoides extracts in children. METHODS: Of children older than four years who had visited Bundang CHA Pediatric Allergy Clinic, those showing positive reactions only to Dermatophagoides in the skin prick test and to the nasal provocation test were included. In all, 11 and 12 patients respectively preferred conventional and ultra-rush immunotherapy. We elevated allergen concentrations diluted to 1,0001 of the end strength by 2-3 times with 30-minute intervals and checked oxygen saturation, pulse rate, blood pressure, and systemic reactions every 15 minutes. Immunotherapy effectiveness was valued by changes in nasal provocation test scores before and after immunotherapy. RESULTS: The average ages of patients in the conventional and ultra-rush immunotherapy groups were 8.3+/-2.3 and 9.2+/-2.8 years, respectively. Systemic reactions were observed in six in the ultra-rush group (50%) without anaphylaxis and one (9%) in the conventional group. The average scores in the nasal provocation test before and after treatment in the conventional group were 8.2+/-1.5 and 4.6+/-2.1, respectively (P=0.043). In the ultra-rush immunotherapy group, the scores changed from 6.2+/-2.2 to 3.7+/2.5 (P=0.017). CONCLUSION: Ultra-rush immunotherapy using Dermatophagoides in children is effective for treating allergic disease but can induce systemic effects rather than conventional immunotherapy.