Gemeinsame Jahrestagung der Deutschen Gesellschaft für Kinderheilkunde und Jugendmedizin und der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde 1997 Begrüßung durch den Tagungspräsidenten

Ohne Zusammenfassung     

Clinical characteristics of patients with repeated systemic reactions during specific immunotherapy with hymenoptera venoms

In general, specific immunotherapy with hymenoptera venoms can be considered as safe, but occasionally there are patients who cannot reach the maintenance dose due to repeated systemic reactions (RSR) or who suffer from RSR during maintenance therapy. In a multicenter retrospective study comprising seven departments in Germany, Austria and Switzerland 23 patients with RSR were reported from approximately 3000 patients treated with hymenoptera venoms (bee and wasp venom to approximately equivalent frequency). From these, 22 were allergic to bee venom and only one to vespid venom. In general the clinical symptoms of RSR were milder than the initial reaction. But 4/23 (18%) exhibited cardiovascular reactions up to full shock. Neither anamnestic details, reactivity in skin tests or in vitro tests revealed a special pattern of patients with RSR. In some patients, however, an extremely high reactivity in the skin test was found and may indicate the possibility of further RSR.     

Long term follow up after parenteral specific hyposensitization in children (author's transl)]

The long term follow up of 55 children with allergy treated by specific hyposensitization therapy is reported. Hyposensitization therapy had been terminated from 2--7 years previously. The success of treatment was subjectively judged to be satisfactory of good in 62% of the cases. In the group of asthmatic children, asthma attacks had decreased or ceased in 74% of the cases: in children with hay fever only 24% continued to have as many or more symptoms as before treatment. In children with asthma and pollen allergy, the success rate was slightly higher with aqueous extracts (68%) than with pyridine-extracted and alum-precipitated extract administration (43%). Also in children with hay fever symptoms alone the use of aqueous extracts seemed to bring somewhat better results (57% with good or satisfactory success) in comparison with pyridine-extracted and alum-precipitated extracts (45%). Side effects of hyposensitization therapy occured in 29 children (53%).     

Smooth muscle hamartoma associated with Becker's nevus

Two cases of smooth muscle hamartoma with Becker's nevus are reported. Clinically and histologically the lesions resemble Becker's nevi with the exception that on histologic examination a hamartomatous proliferation of smooth muscle is prominent.     

Increased sensitivity and specificity of a sandwich ELISA for measurement of IgE antibodies

We have developed a sandwich enzyme-linked immunosorbent assay (ELISA) for measurement of IgE antibodies to the bee venom allergens phospholipase A2 (PLA2) and hyaluronidase (HYAL). The assay is 10-20 times more sensitive than conventional indirect ELISA or radioallergosorbent test (RAST). Furthermore, by using affinity purified rabbit antibodies to these allergens, the specificity of the test was increased compared to RAST. The use of antibodies to link the antigen to the solid phase removes the dependence on the individual protein's ability to bind to the microtitre plate. The increased sensitivity of the sandwich assay seems to be due to better presentation and retention of antigen on the solid phase.     

Advantages of hyposensitization with a high dose of allergoid in pollen allergy

Grass and rye pollen sensitive children were hyposensitized with glutaraldehyde-modified, tyrosine-adsorbed grass and rye allergoid. We evaluated the clinical efficacy and immunological changes associated with the administration of 3100 NOON-Units (NU) with 3 injections in 15 patients (group A) and 9100 NU with 6 injections in 13 patients (group B) preseasonally. No systemic side effects during therapy were observed. In patient's assessments, a clinical improvement was reported; however, group B achieved better symptom and medication scores. The latter group obtained slightly higher specific IgG levels than group A after two seasons of treatment, whereas the co-seasonal increase of specific IgE was higher in group A. Hyposensitization with grass and rye allergoid is a safe therapy, a better clinical and immunological effect being observed in a high dose regimen.