From: Systemic reactions to subcutaneous allergen immunotherapy: real-world cause and effect modelling
Patient number | Age | Gender | Relevant comorbidities | Reaction grade (WAO) | Time to reaction (min) | Pollen prevalence | Extract content | Extract volume (all patients were on 1:1 concentration of extract) | Risk factor |
---|---|---|---|---|---|---|---|---|---|
1 | 23 | Female | None | 3 | 5 | None | 1st vial 1. Dust mite 2. Cat 2nd vial 1. Mixed tree 2. Grass 3. Ragweed | 0.3 mL | 1. Accidental omission of pre-mediation (Rupatadine, 10 mg, PO) 2. First injection from a new serum vial |
2 | 22 | Female | None | 2 | 60 | None | 1. Cat 2. Ragweed | 0.5 mL (maintenance) | High intensity exercise 1 h prior to injection |
3 | 52 | Male | Asthma | 2 | 5 | Grass (high), Walnut (high), Tree (high) | 1st vial 1. Dust mite 2. Cat 2nd vial 1. Grass 2. Ragweed 3. Birch 4. Walnut | 0.15 L | 1. Seasonal exacerbation: a build-up dose that included walnut, grass, and tree allergens was given during peak pollen season 2. ACE inhibitor (Perindopril) was taken the day of the injection 3. NSAID (Naproxen) was taken the day prior to the injection 4. Previous large local reaction |
4 | 17 | Female | None | 2 | 15 | Grass (low; high the prior week) | 1. Dust mite 2. Cat 3. Ragweed 4. Grass | 0.1 mL | 1. First injection from a new serum vial 2. History of previous systemic reactions to SCIT 3. Seasonal exacerbation: a build-up dose was given during moderately high grass pollen season |
5 | 25 | Female | Asthma | 2 | 30 | Grass (low), Cladosporium (high) | 1. Dust mite 2. Cat 3. Cladosporium 4. Grass 5. Black walnut | 0.5 mL | 1. History of previous systemic reaction to SCIT 2. Seasonal exacerbation: a maintenance dose coincided with high cladosporium counts |
6 | 37 | Female | Asthma | 2 | 15 | Trees (medium), weeds (low) | 1st vial 1. Dog 2. Cat 3. Alternaria 2nd vial 1. Grass 2. Ragweed 3. Birch 4. Elm | 0.05 L | 1. Uncontrolled asthma 2. First injection from a new serum vial 3. Error in administration suspected: the injection site did not appear subcutaneous 4. Seasonal exacerbation: a build-up dose was given during peak pollen season |
7 | 33 | Female | Asthma | 2 | 40 | Grass (low) | 1st vial: 1. Dust mite 2. Cat 3. Dog 2nd vial 1. Grass 2. Ragweed 3. Birch 4. Oak 5. Walnut 6. Box elder 7. Sycamore | 0.5 mL | 1. History of previous systemic reactions to SCIT 2. Uncontrolled asthma |
8 | 33 | Male | None | 1 | Unknown, time not documented | None | 1. Box elder 2. Birch 3. Sycamore 4. Mulberry 5. Walnut 6. Grass 7. Ragweed | 0.5 mL | None |
9 | 29 | Female | None | 1 | 5 | None | 1. Dust mite 2. Grass 3. Ragweed 4. Walnut | 0.2 mL | None Note: This patient was experiencing longstanding respiratory and cardiac symptoms of unknown etiology at the time of the reaction |
10 | 32 | Female | Asthma | 1 | 15 | None | 1st vial 1. Box elder 2. Birch 3. Walnut 4. Grass 5. Ragweed 2nd vial 1. Dust mite 2. Cat | 0.1 mL | First injection from a new vial |