Efficacy of a short pretreatment with omalizumab in children with anaphylaxis to hymenoptera venom immunotherapy A report of three cases

Catherine Droitcourt (1) , Claude Ponvert (2, 3, 4) , Alain Dupuy (1) , Pierre Scheinmann (2, 3, 4) , Rola Abou-Taam (2, 3, 4) , Jacques de Blic (3, 2, 4, 5) , Guillaume Lezmi (2, 3, 4, 5)

1 REPERES - Recherche en Pharmaco-épidémiologie et Recours aux Soins
2 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
3 CHU Necker - Enfants Malades [AP-HP]
4 Service de Pneumologie Allergologie [CHU Necker]
5 UPD5 - Université Paris Descartes - Paris 5

Hymenoptera venom allergy is the second cause of anaphylaxis in European children. Systemic reactions occur in up to 0.8% of schoolchildren. Venom immunotherapy (VIT) is recommended in sensitized children having systemic skin reactions exceeding generalized skin symptoms. VIT carries an 8–20% risk of systemic adverse events. Short protocols achieve the maintenance dose faster than conventional protocols but are more frequently associated with anaphylactic reactions. We report the cases of teenagers who experienced severe anaphylactic reactions (SAR) during the rush phase of VIT (Table 1). After an informed consent, a second rush VIT was performed after a pretreatment with omalizumab and was tolerated. No injection of omalizumab was required during the maintenance phase.

Keywords: Hymenoptera venom allergy; Anaphylaxis; Children

Domains: Life Sciences [q-bio]; Immunology; Allergology; Life Sciences [q-bio]; Immunology; Immunotherapy

Catherine Droitcourt, Claude Ponvert, Alain Dupuy, Pierre Scheinmann, Rola Abou-Taam, et al.. Efficacy of a short pretreatment with omalizumab in children with anaphylaxis to hymenoptera venom immunotherapy A report of three cases. Allergology International, 2019, 68 (2), pp.268-269. ⟨10.1016/j.alit.2018.09.003⟩. ⟨hal-01903058⟩