The Local and Systemic Reactions Due to Sublingual Immunotherapy: Is Anaphylaxis Associated with Therapy?

Sublingual immunotherapy (SLIT) is an allergen specific immunotherapy method which has been used extensively instead of subcutaneous immunotherapy (SCIT). Even though it is considered as the last resort, it is often used combined with pharmacotherapy due to simplicity of application. SLIT has been reported to be effective in seasonal allergic rhino-conjunctivitis treatment of adults and it is tolerated well.1 Although the systemic reviews support using SLIT in the allergic children, the experience is little and not conclusive on efficacy of SLIT. It is shown to be reliable and effective from 2 years of age.2-4 Nevertheless, SLIT is currently being used worldwide and serious side effects are rarely reported. The risk for systemic side effects is minimal.5 The well-known local side effects are intraoral (sublingual) itching, lip-lingual swelling, and gastrointestinal system (GIS) complaints.4 Oral and GIS side effects are usually seen in those who used SLIT with grass pollen tablets.6,7 Complaints such as exacerbations of asthma or rhinitis symptoms, urticaria, angioedema etc. are noticed in less than %20 of patients.8 Fatigue and worsening eczema are rarely reported.