Sublingual allergen-specific therapy in a child with diabetes mellitus

Abstract

A description of a clinical case of a pediatric patient (boy, age 12 at the start of observation) with pollen allergy (allergic rhino-conjunctivitis to grass pollen) in combination with insulin-dependent diabetes mellitus is presented. Initiation criteria of allergen-specific immunotherapy (clear seasonal peak of exacerbations, high and concordant data of allergotesting In vivo and In vitro, progredient course of pollinosis clinical signs during years before allergen-specific immunotherapy was started) discussed in case of comorbid patient. Possible risks were analyzed and absence of diabetes mellitus as contraindication for immunotherapy stated. The patient underwent 2 pre-coseasonal courses of sublingual immunotherapy with grass pollen allergens in 2020 and 2021 with a pronounced positive effect. In the second year of treatment, remission of the disease was achieved: almost complete absence of hay fever symptoms in the flowering season of 2021, no progression of the disease, a significant decrease in the need for therapy to relieve symptoms. During the course of therapy, the patient did not show any deterioration in the course of diabetes mellitus, and the daily dose of insulin did not change. The patient is being monitored, and the third course of sublingual immunotherapy with grass pollen allergens is started.