Abstract
Allergic rhinitis developing in childhood typically follows a protracted course and involves the prolonged use of medication. Allergen immunotherapy has been described as having the potential to modify the natural course of allergic rhinitis and bronchial asthma. We describe the case of a child for whom mite allergen subcutaneous immunotherapy was used to treat concomitant allergic rhinitis and bronchial asthma. After therapy, improvements were seen in rhinitis symptoms and degree of impairment of daily living. Coughing also improved and peak flow rate was not decreased even after reducing the dose of medication. Allergen immunotherapy has been reported not only to improve symptoms and reduce medication usage, but also to inhibit new sensitizations and asthma onset, and should therefore be considered as a treatment option in some pediatric patients. Sublingual immunotherapy is currently not indicated in Japan for children under 12 years old, and subcutaneous delivery is the only indicated route of administration. However, subcutaneous immunotherapy can be painful and is only offered by a limited number of medical institutions, constraining the number of children that can receive this therapy. Our hope is therefore that the indications for sublingual therapy will be expanded in the future to include pediatric patients.
