Immunotherapy failure.

A great deal of the immunotherapy failures are preventable if certain criteria are met and guidelines followed. It is mandatory that immunotherapy only be used for those conditions known to be atopic IgE-mediated diseases. With an IgE mechanism established as a foundation for immunotherapy, adherence to certain guidelines (Table 9) will ensure an optimal response to specific therapy. Experience in recent years with in vitro allergy (Table 10) testing in conjunction with or as a replacement for skin testing has resulted in greater efforts as discontinuing immunotherapy previously placed on this treatment, for whom the original diagnosis of allergy cannot be confirmed based on stringent criteria for identifying an IgE-dependent genesis. Too many patients are treated by immunotherapy on the basis of minimal reactions to skin testing or of coincidentally positive skin tests unrelated to the etiology of the patient's complaints.