Resumo

AREDE, Cristina; SAMPAIO, Graça; BORREGO, Luís Miguel  e  MORAIS-ALMEIDA, Mário. Ultrarush specific’s immunotherapy safety using modified extracts in pediatric age. Rev Port Imunoalergologia [online]. 2013, vol.21, n.2, pp.91-102. ISSN 0871-9721.

Introduction: Conventional subcutaneous immunotherapy with allergenic extracts, besides its slowness, has been shown to be potentially associated with adverse reactions. In recent studies, it has been demonstrated that using modified extracts, namely allergoids, is safe and effective, particularly on accelerated schedules, such as ultrarush. However, studies assessing its safety in children are scarce. Objective: To evaluate the safety profile in a pediatric population, using standardized modified allergen extracts, depigmented, polymerized with glutaraldehyde, in an ultrarush protocol to reach the maintenance dose. Material and methods: We included in the present study all children undergoing treatment with subcutaneous immunotherapy modified allergen extract of mites or pollens, that made a ultrarush induction phase during the last five years. We recorded the type of adverse reactions and the clinical approach. Results: We studied 100 children (57 male) with a mean age of 11.6 years (5 to 18 years, standard deviation 3.3), all with persistent moderate to severe rhinitis with or without allergic conjunctivitis, asthma and atopic eczema, sensitized to mites and/or pollens. All reached the maintenance dose in the first day, except one child, and 199 was the total number of injections during ultrarush protocol. There were 21 local adverse reactions in 11 patients, 11 immediate and 10 delayed; have clinical relevance 1 immediate and 4 delayed. Systemic reactions were recorded in two cases, both immediate and mild. A total of 1347 subcutaneous injections were administered during maintenance phase. There were 4 adverse reactions in 4 patients, 3 local and 1 mild systemic. Conclusions: The ultrarush protocol, without premedication, prescribed by allergists, is a safe alternative for use in children in the induction phase of subcutaneous immunotherapy using allergoid polymerized extracts. During the maintenance phase the extract was also highly safe.

Palavras-chave : Aeroallergens; allergoids; paediatrics; safety; specific immunotherapy; ultrarush.

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