Immunotherapy or desensitistaion is an elective form of therapy and is effective in those patients who have IgE-mediated sensitivity to an allergen. Success rates vary according to allergen and the contribution it makes to the disease process.
There are no hidden long-term complications of immunothearpy. However, there is still a risk of side effects which may range from mild local swelling to anaphylaxis. The likelihood of anaphylaxis is 0.1-0.2% per injection and the episode will almost invariably occur within 45 minutes.
THE PATIENT MUST BE OBSERVED THIS PERIOD OF TIME.
Asthmatics are more prone to acute reactions and may develop either anaphylaxis or life-threatening asthma. This is more likely to occur if the asthma is unstable at the time of injection. Pre-injection assessment by means of peak flow meter, enquiry about night wheeze, bronchodilator frequency, etc. is strongly recommended. Worsening in asthma may also occur within 24-48 hours of injection and, if present, indicates the need for dose reduction.
Injections should only be administered in a surgery setting where treatment of anaphylaxis is possible. In particular, adrenaline must be available and the doctor must be conversant in the treatment of anaphylaxis.
The allergen injections should be given in the lower, outer part of the upper arm. If a systemic reaction occurs, immediately administer adrenaline intramuscularly.
Please cease further immunotherapy treatmeant and contact us of the event.
Local reactions - <5.0cm - continue per schedule
Local reactions - 5.0-10.0cm - repeat dose
Local reactions - 10cm - lower next dose by 25%