Rush venom immunotherapy in patients experiencing recurrent systemic reactions to conventional venom immunotherapy.
BACKGROUND
An unknown number of venom-allergic patients fail to reach the maintenance dose (MD) during the build-up period of conventional venom immunotherapy (VIT) due to recurrent systemic reactions (SRs).


OBJECTIVE
To establish an alternative VIT protocol that will enable these patients to reach a full protective MD.


METHODS
Venom-allergic patients who had experienced recurrent SRs during the build-up period of conventional VIT underwent rush VIT.


RESULTS
Of the 9 patients who participated in this study, the 6 who underwent 8 treatment courses tolerated the rush VIT well and reached the MD within 3 days. In 3 of these patients, mild cutaneous SRs were overcome with loratadine. In 2 patients who experienced recurrent and more severe SRs, the original 3-day rush VIT had to be modified and extended to 5 days until the MD was reached. In a single patient who experienced an anaphylactic reaction, VIT was discontinued.


CONCLUSIONS
Rush VIT is an appropriate therapeutic alternative that enables most patients with recurrent SRs throughout the build-up period of conventional VIT to reach a full protective MD.
Goldberg
Arnon
A
Allergy and Clinical Immunology Unit, Meir General Hospital, Kfar Saba, Israel. arnong@clalit.org.il
Confino-Cohen
Ronit
R
D000707:Anaphylaxis / Q000209:etiology; D000818:Animals; D001514:Bee Venoms / Q000008:administration & dosage / Q000009:adverse effects*; D003888:Desensitization, Immunologic / Q000009:adverse effects*; D004306:Dose-Response Relationship, Immunologic; D004334:Drug Administration Schedule; D006801:Humans; D007299:Insect Bites and Stings; D013997:Time Factors; D014862:Wasp Venoms / Q000008:administration & dosage / Q000009:adverse effects*
D001514:Bee Venoms; D014862:Wasp Venoms