title: Safety of sublingual grass pollen immunotherapy after anaphylaxis.
abstract: OBJECTIVE
  To demonstrate that sublingual immunotherapy is a safe treatment option in patients who have previously suffered anaphylaxis when undergoing subcutaneous grass pollen immunotherapy.
  
  
  METHODS
  We report two patients who developed a systemic anaphylactic reaction following subcutaneous grass pollen immunotherapy, resulting in discontinuation of treatment. Following treatment of the acute anaphylactic episode, both patients were subsequently safely commenced on sublingual grass pollen immunotherapy.
  
  
  CONCLUSIONS
  Injection immunotherapy has a relatively low risk of severe adverse events, although anaphylaxis is a potentially fatal complication and usually results in termination of the immunotherapy programme. Sublingual immunotherapy has a safer side effect profile than subcutaneous immunotherapy, with no reported cases of anaphylaxis.
authors.affiliation: Department of Otolaryngology, Lancashire Teaching Hospitals NHS Trust, Preston, UK. jayanichani@hotmail.com
authors.forename: J R
authors.initials: JR
authors.lastname: Nichani
authors.forename: J
authors.initials: J
authors.lastname: de Carpentier
mesh_terms: D000286:Administration, Sublingual; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000008:administration & dosage*; D000707:Anaphylaxis / Q000517:prevention & control*; D003888:Desensitization, Immunologic / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007279:Injections, Subcutaneous / Q000009:adverse effects; D008297:Male; D006109:Poaceae; D011058:Pollen / Q000276:immunology*; D012130:Respiratory Hypersensitivity / Q000276:immunology / Q000628:therapy; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000485:Allergens