Allergy Partners of Chapel Hill, Chapel Hill, NC.
Division of Immunology, Allergy and Rheumatology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
J Allergy Clin Immunol Pract. 2016 Sep-Oct;4(5):862-7. doi: 10.1016/j.jaip.2016.04.007. Epub 2016 May 18.
Subcutaneous allergen immunotherapy (SCIT) clearly benefits appropriately selected patients with allergic rhinitis, asthma and anaphylaxis to stinging insects. Since inception of SCIT, systemic allergic reactions (SRs) and severe anaphylaxis have been risk management challenges facing the practicing allergist. Recently it has estimated that 14% of reported SRs begin at least 30 minutes after injection administration or after the 30 minute recommended clinic observation period. Faced with the possibility that SRs could occur after the patient leaves the clinic, some practicing allergists routinely prescribe epinephrine auto-injectors to all injection patients. This article summarizes the key arguments for and against routine prescription of epinephrine auto-injectors for all allergen injection patients, discussed in a PRO/CON debate at the 2015 AAAAI meeting. Currently, there is insufficient clinical evidence to make a strong recommendation for or against this practice.
皮下变应原免疫疗法（SCIT）显然使适当选择的变应性鼻炎、哮喘和昆虫叮咬过敏患者受益。自 SCIT 问世以来，全身性过敏反应（SRs）和严重过敏反应一直是实践变态反应学家面临的风险管理挑战。最近据估计，报告的 SRs 中有 14%至少在注射后 30 分钟或在推荐的 30 分钟门诊观察期后开始。由于有可能在患者离开诊所后发生 SRs，一些实践变态反应学家通常为所有注射患者开具肾上腺素自动注射器。本文总结了在 2015 年 AAAAI 会议的 PRO/CON 辩论中讨论的，支持和反对为所有过敏原注射患者常规开具肾上腺素自动注射器的主要论点。目前，尚无充分的临床证据支持或反对这种做法。
