Patient Age
ÎImmunotherapy for children is effective and well tolerated. It has been shown to prevent the new onset of allergen sensitivities in monosensitized patients, as well as progression from allergic rhinitis to asthma. Therefore immunotherapy should be considered along with pharmacotherapy and allergen avoidance in the management of children with allergic rhinitis/rhinoconjunctivitis, allergic asthma, and stinging insect hypersensitivity. (B)
ÎImmunotherapy can be initiated in young children. Indications are similar to those of other age groups. (D)
ÎIn patients who otherwise have the indication for specific immunotherapy, there is no absolute upper age limit for initiation of immunotherapy. (D)
Pregnancy
ÎAllergen immunotherapy can be continued but is usually not initiated in the pregnant patient. (C)
ÎIf pregnancy occurs during the build-up phase and the patient is receiving a dose unlikely to be therapeutic, discontinuation of immunotherapy should be considered. (D)
Immune Disorders
ÎImmunotherapy can be considered in patients with immunodeficiency and autoimmune disorders. (C)
Comorbid Conditions
ÎAllergen immunotherapy in asthmatic patients should not be initiated unless the patient's asthma is stable. (C)
ÎMedical conditions that reduce the patient's ability to survive the systemic allergic reaction or the resultant treatment are relative contraindications for allergen immunotherapy. Examples include severe asthma uncontrolled by pharmacotherapy and significant cardiovascular disease. (C)
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