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Abstract
SUMMARY AND CONCLUSION
This study was carried out on fifty allergic asthmatic children from Allergy and Clinical Immunology unit, Zagazig University Hospital, 29 of them were of moderate asthma and 21 were of severe asthma.
The diagnosis of asthma was achieved by:
1- Through history and clinical diagnosis by presence of recurrent wheezes, cough, chest tightness and dyspnea.
2- Plain x-ray chest to rule out other pulmonary pathology.
The clinical types of asthma were diagnosed by:
1- Skin test by intradermal method for the common allergens: house dust, house dust mite, cotton dust, mixed pollens, straw, hay dust and wool.
2- Total serum IgE level.
3- Medication that were used to control symptoms.
4- Number of nocturnal asthmatic attacks.
The specific injectable immunotherapy (SIT) was given to active group patients in this study by stepwise subcutaneouse injection of increasing concentrations of allergen to which the patients is sensitive twice weekly, starting by a concentration of 1/2000 aqueous solution of allergenic extract then 1/1000, then 1/500, then 1/250 then 1/125.
Once the patients reached their full or ’maintenance’ concentration of 1/100 they were maintained on the maximally tolerated dose of concentration for 6 months.
Immunotherapy was administered according to preseasonal schedule 6 months before the pollen season. The patients maintained on the maintenance dose until beginning of the pollen season then immunotherapy was stopped (Rapiejko and Ligezinski, 1997).
The patients were evaluated before, after and between injections to register the patient’s condition and any immediate (15 min.) and late (6 hours) reaction to allergen injected.
The control group was not given SIT and continued their medical treatment.
The patients were evaluated for 6 months by:
1- Clinical evaluation by symptom and medication scores before and after SIT by score 0-3.
2- Immunologic evaluation before and after SIT by:
a) Total serum IgE.
b) Total serum IgG.
Our results were tabulated, subjected to statistical analysis and following conclusions were reached:
• Significant improvement in symptom and medication scores were observed after SIT in all patients.
• Significant decrease in serum IgE level after SIT in all patients.
• Significant increase in serum IgG level after SIT in all patients.
• So, SIT is considered as a line of treatment for allergic patients with daily pharmacotherapy in asthma and allergic rhinitis.
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