The Systemic Adverse Reactions Of Specific Immunotherapy In704Children Of Asthma

ObjectiveTo explore the systemic adverse reactions of standardized dust-mitesvaccine for the treatment in children of asthma.MethodsRetrospective analysis704dust-mites allergic children of asthma whohad specific immunotherapy. Monitoring the immediate and late side-effectsafter each allergen injection during immunotherapy treatment andmonitoring the changes of peak expiratory flow. Especially Collected the18injections of serious systemic adverse reactions’ treatment.ResultsIn these704dust-mites allergic children of asthma, there were396children had specific immunotherapy for equal or more than3years,142children for2to3years,105children for1to2years,51children for equalor less than1year (including39children in Starting treatment), and10children terminated specific immunotherapy because of adverse reactions.The adverse reactions included causing or worsening rhinitis (3cases),causing cough (2cases), systemic hypersensitivity reactions(2cases), causing anorexia(1case), cellulitis(1case), red and swollen(1case).17.0%(120/704) children caused systemic side-effects and72.7%(512/704) children caused local reaction．There were336injectionscaused systemic side-effects, including335injections which causedimmediate mild systemic side-effects within30min after injection and1injection which caused late systemic side-effects．The336injections weremainly appeared in maintenance treatment phase and mainly performancedfor acute asthma attacks such as cough, chest distress, wheezing and urticaria.According to the systemic adverse reaction grading standards,0level28injections (8.3%), l level117injections (34.8%),2level173injections(51.5%),3level18injections (5.4%).No any severe systemic adversereaction such as anaphylactic shock was showed in this study. All the120dust-mites allergic children of asthma who had systemic adverse reactions ofspecific immunotherapy had PEF fallen more than20%after the injection. Inthese cases, there were18injections appeared PEF>20%immediately. Allof the18injections were immediate mild systemic side-effects and mainlyperformanced for acute asthma attacks such as cough, chest distress,wheezing and urticaria. The time of serious systemic adverse reactionsappeared after injections was:<5min2injections,5~10min2injections,10~152injections,15~20min2injections and20~30min10injections.All of them were given spasmolysis atomization, dexamethasoneintravenous push and (or) adrenaline intramuscular injection and antihistamines per os immediately. After these treatments, all of them wererelieved after soon. The recovery time was:<15min3injections,15~30min5injections,30min~1hour9injections and1~2hour1injections. Agemainly happened for5-10years, with6~9years old, there were63caseswhich’s ratio in the total incidence rate of systemic adverse reactions was52.5%. The season mainly focused on June to August, followed bySeptember to November. Comparing the rates of local adverse reaction andsystemic adverse reaction, there were statistically significant differences andit showed that local adverse reaction had certain prediction effect forsystemic adverse events.ConclusionThe serious systemic adverse reactions of specific immunotherapy wererelatively low and all of them had a good prognosis after immediatetreatment. Therefore, subcutaneous SIT with standardized dust mite extractshowed a good tolerance in children of allergic asthma.