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Table 3 Summary of patients with grade 4 reactions

From: A single centre retrospective study of systemic reactions to subcutaneous immunotherapy

Age—yr, gender Reaction year, season Asthma Food allergies SCIT dose New serum SCIT content Reaction onset and symptom description Treatment
53, male 2012, winter Yes None Vial 4, 0.25 ml No Grass, Ragweed, Trees Few minutes; flushing, throat tightness, feeling unwell, systolic blood pressure 70 mmHg Epinephrine 0.5 ml IM then 0.3 ml IM, salbutamol and normal saline. Patient was transferred to the hospital.
16, male 2013, autumn Yes Peanut and tree nuts Vial 4, 0.25 ml Yes Dust mites, Ragweed, Trees, Mold, Cat 30 min; shortness of breath, urticaria, flushing, throat tightness, nausea, swelling of the eyes, chest tightness, blood pressure 49/29 upon standing in the hospital Epinephrine 0.5 ml IM in clinic followed by two injections of epinephrine 0.3 ml IM in the hospital, salbutamol, prednisone, antihistamines and normal saline. Patient was transferred to the hospital
35, male 2016, winter No None Vial 4, 0.10 ml Yes Dust mites, Grass, Ragweed, Trees, Cat Immediate; flushing, feeling unwell, lightheadedness, blood pressure 65/40 mmHg after epinephrine was given Epinephrine 0.5 ml IM then 0.3 ml IM and normal saline. Patient was transferred to the hospital
  1. SCIT subcutaneous immunotherapy, mmHg millimeter of mercury, IM intramuscular