Algorithm for selecting patients for house dust mite allergen specific im- munotherapy in children with bronchial asthma and allergic rhinitis

Abstract

Objective. Based on literature data and own research, on the selection of pediatric patients for the treatment of allergen immunotherapy (AIT) with house dust mite (HDM) allergens, to develop an Algorithm for selecting patients for AIT with HDM allergens in children with bronchial asthma (BA) and allergic rhinitis (AR). Methods. Data from our own studies included 420 patients with AR and complaints indicating domestic sensitization (256 boys, 164 girls), aged 5 to 17,9 years (mean age 8,44 ± 3,06), of which 176 have had BA. Patients underwent skin prick tests (SPT) with household allergens, determination of sIgE for HDM allergens by the ImmunoCAP method, and nasal provocative test (NPT) with HDM. If the results were negative, the allergological examination was repeated again in 12–18 months. Results: The Patient Selection Algorithm was constructed on the basis of the obtained data on the significance of the examination methods used. The primary role of SPT, the possibility of repeating the examination in case of negative results, indications for NPT with HDM allergens were taken into account. The algorithm makes it possible to organize an examination of a patient with HDM allergy in order to develop indications for AIT.

Keywords

• allergic rhinitis
• bronchial asthma
• children
• allergen immunotherapy
• house dust mite