Dealing with absolute and relative contraindications to specific immunotherapy using Hymenoptera venoms

AbstractBackgroundAcute infectious disorders, uncontrolled bronchial asthma, severe chronic inflammatory disorders, severe cardiovascular disorders, autoimmune or immunodeficiency disorders, active or progressive cancer, acquired immunodeficiency syndrome (AIDS), treatment initiation during pregnancy, as well as medication with β‑blockers and angiotensin-converting enzyme (ACE) inhibitors, among others, are considered either absolute or relative contraindications to specific immunotherapy using Hymenoptera venom (HV-SIT). Some of the contraindications listed above, however, are potential risk factors in the event of ana phylaxis, such that one regularly needs to challenge these contraindications on a case-by-case basis so as not to withhold HV-SIT from patients at particularly high risk.MethodsLiterature review.Results and conclusionStudy data on a  risk-increasing effect are available for only some of the contraindications to HV-SIT listed in the product information or guidelines. Moreover, these data are partially conflicting. Nevertheless, acute infectious disorders, active autoimmune disorders during flare-ups, active or progressive malig nant disease, uncontrolled bronchial asthma, AIDS, and treatment during pregnancy are considered absolute contraindications to the initiation of HV-SIT. Some of these contraindications are, by their very nature, temporary. In other cases, therapy can be initiated once the underlying disease has been optimally treated. Relative contr...
Source: Allergo Journal International - Category: Allergy & Immunology Source Type: research