[A modified ultra-rush-protocol of allergen immunotherapy in children and adolescents with insect venom allergy].
BACKGROUND
In Germany the prevalence of insect venom allergy in the population is about 5 %, 10-40 deaths are reported every year. With a success rate of 95 % venom immunotherapy (SIT) has a convincing protective effect. The purpose of this study was to investigate the safety of the original ultra-rush-protocol in children and reduce from 9 to 8 doses by avoiding a second application of 100 micro g insect venom.


METHODS
Nineteen children and adolescents with insect venom allergy were treated according to the modified ultra-rush-protocol. The first 5 children were hyposensitized according to the original protocol suggested by Brehler et al., the remaining 14 children (age 6-18 years) received only 8 injections (0.01/0.1/1/10/20/40/80/100 micro g). 5 patients were discharged on the second day four hours after the final application of 100 micro g insect venom.


RESULTS
Extensive reddening due to inflammation was found in injection spot in 5 patients. Four patients had an amplified wheal formation. No systemic reactions were observed. The maintenance therapy was well tolerated.


CONCLUSIONS
The modified ultra-rush-protocol increases compliance by short inpatient stay. In addition the modified hyposensitization was sure and well tolerated.
Steiss
J O
JO
Zentrum für Kinderheilkunde und Jugendmedizin des Universitätsklinikums Giessen. Jens-Oliver.Steiss@paediat.med.uni-giessen.de
Hüls
G
G
Gortner
L
L
Lindemann
H
H
D000293:Adolescent; D001514:Bee Venoms / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D002648:Child; D003692:Delayed-Action Preparations; D003888:Desensitization, Immunologic / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology* / Q000628:therapy; D007279:Injections, Subcutaneous; D007299:Insect Bites and Stings / Q000276:immunology*; D008297:Male; D010343:Patient Admission; D016896:Treatment Outcome; D014862:Wasp Venoms / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*
D001514:Bee Venoms; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D014862:Wasp Venoms