The Journal of Laryngology & Otology

Clinical Records

Safety of sublingual grass pollen immunotherapy after anaphylaxis

J R Nichania1 c1 and J de Carpentiera1

a1 Department of Otolaryngology, Lancashire Teaching Hospitals NHS Trust, Preston, UK


Aim: To demonstrate that sublingual immunotherapy is a safe treatment option in patients who have previously suffered anaphylaxis when undergoing subcutaneous grass pollen immunotherapy.

Case report: We report two patients who developed a systemic anaphylactic reaction following subcutaneous grass pollen immunotherapy, resulting in discontinuation of treatment. Following treatment of the acute anaphylactic episode, both patients were subsequently safely commenced on sublingual grass pollen immunotherapy.

Conclusion: Injection immunotherapy has a relatively low risk of severe adverse events, although anaphylaxis is a potentially fatal complication and usually results in termination of the immunotherapy programme. Sublingual immunotherapy has a safer side effect profile than subcutaneous immunotherapy, with no reported cases of anaphylaxis.

(Accepted April 07 2008)

(Online publication May 23 2008)


c1 Address for correspondence: Mrs J R Nichani, 14 Uplands Chase, Fulwood, Preston PR2 7AW, UK. Fax: 01772 523233 E-mail:


Mrs J R Nichani takes responsibility for the integrity of the content of the paper.

Competing interests: None declared