Allergy Asthma Proc. 2022 Jul 1;43(4):267-271. doi: 10.2500/aap.2022.43.220035.
Subcutaneous allergen immunotherapy (SCIT) is a unique treatment option for managing patients with allergic rhinitis, asthma, atopic dermatitis, and stinging insect allergy. Although systemic reactions to allergen injections are rare, near-fatal, and fatal anaphylactic reactions can occur. Patients with asthma are at greatest risk for more severe reactions as are those with previous systemic reactions. Treating allergists should institute best clinical practices to prevent and manage severe systemic reactions to SCIT, including the following: (1) prescreening patients with asthma for recent increases in asthma symptoms, (2) not prescribing SCIT to patients with severe and uncontrolled asthma, (3) instituting clinic protocols to prevent dosing errors, (4) considering modifying allergen doses during peak allergy seasons in patients at high risk, (5) instituting measures that require all patients on SCIT to be observed for at least 30 minutes after injections, and (6) regular training of all clinical staff in the recognition and expeditious treatment of anaphylaxis.
皮下变应原免疫疗法（SCIT）是治疗变应性鼻炎、哮喘、特应性皮炎和蜂类蜇刺过敏的一种独特治疗选择。虽然对变应原注射的全身性反应罕见，但可能会发生致命性和致死性过敏性反应。哮喘患者的风险最大，既往有全身性反应的患者也是如此。治疗过敏症专家应实施最佳临床实践，以预防和管理 SCIT 的严重全身性反应，包括以下内容：（1）对有近期哮喘症状加重的哮喘患者进行预筛查，（2）不向严重和未控制的哮喘患者开具 SCIT 处方，（3）制定诊所方案以预防剂量错误，（4）考虑在高风险患者的过敏高峰期调整过敏原剂量，（5）采取措施要求所有接受 SCIT 的患者在注射后至少观察 30 分钟，以及（6）对所有临床工作人员进行过敏反应的识别和快速治疗的定期培训。
