engleski

Sublingual immunotherapy (SLIT) with Dermatophagoides pteronyssinus (DP) allergen: case report

Sublingual administration of immunotherapy (IT) has been proved effective among other local IT methods and is indicated in adult patients with allergic rhinoconjuctivitis and/or asthma. Results of two years SLIT treatment with DP allergen is presented. A female patient , 21 years old, born in in a village in northern part of Croatia, now living in Zagreb, reported typical symptoms of perrenial rhinoconjuctivitis which lasted for a year and were more intensive while staying in the village. Before the SLIT, prick test (PT) reactions (urtica) were DP 6x6 mm (hystamine hydrochloride 1 mg/ml 5x4 mm, buffer solution 0 mm), total IgE level was >1000 kU/L, specific IgE (sIgE) to DP 98.2 kUA/L (class 5), nonspecific bronchial challenge test showed bronchial normo-reactivity (PC 20 FEV1 > 8 mg/ml hystamine solution). SLIT was begun in May 1996, with DP allergen (ALK-Epipharm) standardized in 4 concentrations (50, 500, 5000, 50000 SQ-E/ml). Initial phase lasted for 20 weeks with maintenance dose achieved in 40 days. Th only side effects were frequent sneezing and tongue itching during application of maintenance dose. In April 1997, SLIT was continued with maintenance dose for 6 weeks without side effects. Six months after beginning SLIT, PT reactions to DP was 3x3 mm, total IgE 877kU/L, sIgE to DP 9, 78 kUA/L (class 3) and after 18 months PT reaction to DP was 5x5 mm, total IgE 847 kU/L. sIgE to DP 7, 51 kU/L (class 3). Clinical symptoms were reduced to a complete absence of symptoms during stay in the town and mild symptoms were present only on the first day of stay in the village. Results indicate that SLIT is an effective, safe and simple method for administration of IT, but for better use of SLIT more experience is required.

sublingual immunotherapy; prick test; specific IgE; total IgE; dust mites; Dermatophagoides pteronyssinus; perrenial rhinoconjuctivitis

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