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Table 2 Characteristics for patients with systemic reactions to SCIT

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

  1. ACE Angiotensin converting enzyme, NSAID Nonsteroidal anti-inflammatory drug, PO Per os (by mouth), SCIT Subcutaneous immunotherapy, WAO World Allergy Organization
  2. Extract composition: Dust mite extract includes D. Pteronyssinus and D. Farinae. Timothy grass was used for Grass extract. Tree extracts included a mix of relevant pollens for Southwestern Ontario, Canada