@article{StoevesandtHospKerstanetal.2017,
  author    = {Stoevesandt, Johanna and Hosp, Christine and Kerstan, Andreas and Trautmann, Axel},
  title     = {Safety of 100 µg venom immunotherapy rush protocols in children compared to adults},
  series = {Allergy, Asthma \& Clinical Immunology},
  volume    = {13},
  journal   = {Allergy, Asthma \& Clinical Immunology},
  number    = {32},
  doi       = {10.1186/s13223-017-0204-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157830},
  year      = {2017},
  abstract  = {Background: There is a paucity of studies examining the safety of venom immunotherapy (VIT) in children. We aimed to assess the incidence of anaphylactic side effects during rush VIT in a cohort of pediatric patients and adult controls. Methods: 72 consecutive cycles of VIT-buildup in 71 children/adolescents aged 7-17 years were retrospectively evaluated and compared to an adult control group (n = 981) with regard to baseline parameters (sex, causative venom, severity of index sting reaction, results of allergy testing, comorbidities) and the incidence of anaphylactic adverse reactions. Results: Compared to adults, severe index sting-induced anaphylaxis was significantly less common in children (P = .001). Children were more likely to suffer from bee venom allergy (P < .001) and showed higher levels of bee venom-specific IgE (P = .013), but lower serum tryptase concentrations (P = .014). The overall rate of VIT-induced anaphylactic reactions was higher in children than in adults (6.9\% vs 2.5\%, P = .046 by univariate analysis). In the final binary logistic regression model, however, only bee VIT (P = .039; odds ratio 2.25; confidence interval 1.04-4.87) and 5-day compared to 3-day buildup protocols (P = .011; odds ratio 2.64; confidence interval 1.25-5.57) were associated with an increased risk of treatment-induced anaphylaxis. All pediatric patients finally reached and tolerated the target maintenance dose of 100 µg. Conclusions: The higher anaphylactic reaction rate observed in pediatric patients may be attributed to a greater prevalence of bee venom allergy. VIT-induced anaphylaxis in children is usually mild and does not affect further updosing and maintenance of VIT.},
  language  = {en}
}