BMJ 1994;308:201 (15 January)

Letters

Injection immunotherapy

EDITOR, - In A J Frew's article on injection immunotherapy one of the display panels states that insect venom immunotherapy is not recommended in patients with a history of chronic perennial asthma.1 Such advice would be widely accepted when applied to allergen immunotherapy for rhinoconjunctivitis, but I believe it is unnecessary to extrapolate this advice to people allergic to insect venom.

Since 1977 I have been associated with the insect venom allergy clinic at Guy's Hospital, where we have successfully and safely treated many asthmatic patients as well as those with hypertension and even ischaemic heart disease. When anaphylaxis follows either injections or stings asthma is an important risk factor. Most of the deaths reported in young patients receiving injection immunotherapy for inhaled allergens before 1986 were due to acute severe asthma.2 This makes it imperative for asthmatic patients to be desensitised to venom if they have had generalised reactions . . . [Full text of this article]


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