Subcutaneous Desentitisation Exceptional healthcare, personally delivered
What is desensitisation? Desensitisation is a therapy aimed at producing a tolerance to a certain allergen. Treatment is generally reserved for patients with severe allergies, and only then if all the conventional treatments have failed to control the symptoms. Desensitisation involves a course of injections, given as below: Tree & Grass Pollen Allergy Products may vary, but the most common regime is a series of increasing dose injections given every week for three weeks, followed by a further 3 injections given every two weeks (6 injections in total). Treatment is repeated each year for 3 years in total. Venom Allergy A series of increasing dose injections given every week for 12-16 weeks, followed by an injection every 4 weeks, for a further 3 years. House Dust Mite, Cat, all other allergens A series of increasing dose injections, given every week for 12-16 weeks, followed by an injection every 6 weeks, for a further 3 years. What may affect the duration of my treatment? You may need to repeat a dose if the maximum treatment interval is exceeded, which will increase the duration of treatment. Before your appointment? Before your injection you must report any of the following: n Infections, such as coughs and colds. n Any deterioration in asthma or the presence of wheeze. n Any other illness. 2 Subcutaneous Desensitisation
All medications or change in medications Any late reactions to your previous injection (eg. arm swelling). Please report in advance of your appointment if you are taking betablockers by contacting the number at the end of this leaflet. Your injection You will be given your injection into the upper outer part of your arm, below the layers of skin. Are there any side effects? Most patients will have some side effects from treatment. n Commonly occurring side effects include redness, itching and swelling at the injection site. n Less commonly, you may have runny nose, itchy eyes, swelling of lips/face. n Very infrequently, severe reactions may occur that cause difficulty in breathing, light headedness of even anaphylactic shock. If you have side effects, treatment will be provided, based on the severity of your symptoms eg. Antihistamine. In more serious reactions, further medical treatment and possible admission to hospital may be required. What happens after my injection? n You will need to remain in clinic for one hour after your injection. n Report to the nurse before you leave. n Whilst waiting, report any wheeze, runny nose, cough, shortness of breath, rash or light headedness. n Do not exercise vigorously on the day of your injection, as this can speed up the absorption of the allergen and can lead to reactions. Subcutaneous Desensitisation 3
What are my responsibilities? n To commit to the complete programme of treatment. n To attend your allocated appointment times. n To adhere to our protocol. What should I do if I have a delayed reaction when I get home? n If the reaction is a local reaction, take one of the antihistamine tablets that were prescribed for you at the start of your treatment. n If you develop wheeziness or asthma, use your salbutamol inhaler as instructed. n Attend your local accident and emergency department if you fail to respond to the above treatment. If symptoms included shortness of breath or light headedness, call 999. n Inform the Immunology Department that you have had a delayed reaction and/or have attended the accident and emergency department as soon as you are able. 4 Subcutaneous Desensitisation
References BSACI Working Party (1993) Position on Allergy Immunotherapy. Clin Exp Allergy 23, (3), 1-44 Durham, SR, Walker, SM, Varga, EN, Jacobson, MR, O Brien, F, Noble, W, Till SJ, Hamid, QA and Nouri-Aria, KT (1999) Long term clinical efficacy of grass pollen immunotherapy. New England Journal of Medicine. 341, 468-475 Malling, HJ and Weeke, B. (1993) Immunotherapy Position Paper. Allergy. 48, 1-35 Reisman, RE, Arbesman, CE and Lazell, M. (1997) Clinical and Immunogical studies of venom immunotherapy. Clinical Allergy. 9, 167-174 www.allergyuk.org NHS Constitution. Information on your rights and responsibilities. Available at www.nhs.uk/aboutnhs/constitution Subcutaneous Desensitisation 5
www.nbt.nhs.uk/immunology If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. This edition published May 2014. Review due May 2016. NBT002308