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Safety and Efficacy of Hymenoptera and Fire Ant Rush Immunotherapy in Children
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Wiparat Manuyakorn, MD, PhD, Suwat Benjaponpitak, MD, Wasu Kamchaisatian, MD, Cherapat Sasisakulporn, B.Sc., Wanlapa Teawsomboonkit, RN
Rationale:

This study was to evaluate the safety and efficacy of rush immunotherapy (RIT) with hymenoptera and fire ant and identify risk factors for systemic reactions (SRs) in children.

Methods: A 10 year retrospective review was conducted in children receiving hymenoptera and/or fire ant RIT. The 3-days RIT protocol consisted of hourly subcutaneous injections to achieve the maintenance dose 100µg of hymenoptera venom or 0.5 ml of 1: 100 wt/vol fire ant. Safety of RIT was assessed using Subcutaneous Immunotherapy Systemic Reaction Grading System. Efficacy was assessed by the reaction after exposure.

Results:

Fifty children were reviewed: 22 with fire ant, 17 with honey bee, 20 with mixed vespid, 2 with paper wasp RIT. Eleven children received 2 different allergens RIT. The mean age was 10.06+ 2.78 years. 92% of studied children were male. 32 systemic reactions (3.93%) were occurred in 814 RIT shots: 10(1.2%) grade I SRs, 18(2.2%) grade II SRs and 4(0.49%) grade III SRs. There was no association of SRs with age, gender, atopic history, the level of IgE sensitization and type of insect. Among 23 patients experienced accidental exposure, 6 patients had no reaction, 1 patient developed grade II reaction and 3 children with fire ant RIT experienced grade III systemic reaction. However, these gr III reactions were resolved after increased the maintenance dose to 0.5 ml of 1:50 wt/vol fire ant.

Conclusions:

Rush immunotherapy with hymenoptera and fire ant in children is safe and has low severe systemic reaction. It is an alternative treatment for patients requiring rapid protection.