Premedication For Oral Desensitization To Anaphylactoid Reactions At OPD
Monday, March 5, 2018
South Hall A2 (Convention Center)
Kyuchul Choeh, Hye-Young Ryu, You-Sik Jeon
RATIONALE: There are some situations that oral desensitization to a strong allergen has to be unavoidably done at OPD. Premedication before triggering immune reaction can weaken the adverse reactions and reduce the dose of immune suppressive agents. To prevent anaphylactoid reaction during oral desensitization at OPD and to reduce the dose of corticosteroids, premedication protocol is necessary.

METHODS: Children over 5 years of age with symptomatic IgE-mediated allergy to hen’s egg underwent a 17-day oral tolerance induction regimen and were subsequently maintained on the daily intake of a whole boiled egg for 12 weeks. Oral antihistamines and cimetidine were daily taken from day0 for 6 months. Dexamethasone was intramuscularly injected from day4 3 times a week for 3 weeks. Oral challenge of boiled egg white was done from day7 in escalating doses of 8 steps for 17 days. Human Chorionic Gonadotropin (hCG) was intramuscularly injected from day21 3 times a week for 2 weeks and then 2 times a week for 2 weeks. Oral danazol was daily given from day21 for 6 weeks.

RESULTS: Three patients between 5 and 6 years of age entered the protocol. All patients were successfully desensitized to hen’s egg. All patients showed allergic reactions but the reactions in general were mild. The allergic reactions were subsided by additional dexamethasone injection. During follow-up between 1 and 5 years, egg was well tolerated by all patients.

CONCLUSIONS: This premedication protocol is useful and safe for inducing desensitization to ananphylactoid reaction by strong allergen, egg at OPD.