Allergies, dust mites

Mistrello, G., Falagiani, P., Riva, G., Gentili, M., and Antonicelli, L. (1992). Cross-reactions between shellfish and house-dust mite. Allergy 47, 287. 

A 23-year-old man, with a history of asthma, house dust mite allergy, and rhinoconjunctivitis, presented with acute respiratory symptoms. He was given oral cetirizine, inhaled salmeterol, and fluticasone propionate, and oral prednisone 40 mg/day for 1 week and 20 mg/day for 1 week. His asthma recurred when prednisone was withdrawn and he took oral prednisone 60 mg/day for 1 week and 40 mg/day for 1 week. He also took montelukast 10 mg/day. He then developed severe peripheral edema with a gain in weight of 13 kg. Prednisone was withdrawn and his edema resolved. Montelukast was continued. 

The efficacy of subcutaneous SIT has been clearly shown in a metaanalysis of 43 double-blind placebo-controlled trials in allergic rhinitis as well as another meta-analysis of 16 double-blind placebo-controlled studies in asthma patients [13]. The mean clinical improvement was 45% reduction in symptoms and medication compared with placebo in rhinitis and 40% in asthma patients, which exceeds the effects of drug therapy. A recent meta-analysis also confirmed that asthma responds favorably to SIT [14], However, recently it could also be demonstrated that SIT is effective in patients with house dust mite allergy, allergic rhinitis and asthma [15]. Immunotherapy in these patients not only reduced rhinitis and asthma symptoms as well as rescue medication, but also had an impact on bronchial hyperreactivity over the 3-year follow-up period. 

Petrus, M., Cougnaud, V., Rhabbour, M., Causse, E., Netter, J.C. 1997. Snail and house-dust mite allergy in children. Archives De Pediatrie 4(8) 767-769. 

A 14-year-old girl with house dust mite allergy had generalized skin eruptions after taking cetirizine. She also had symptoms of acute hepatitis, which also resolved after withdrawal of cetirizine (16). 

Secondary intervention studies are few. A study in Japan [240(Ib)] identified infants at high risk of house dust mite allergy and asthma postnatally, on the basis of early manifestations of atopy (i.e. eczema and food allergy). Children were enrolled during the 1st year of life and randomised to house dust mite prevention which resulted in a substantial reduction in house dust mite allergen levels. At the 1-year follow-up, children in the active treatment group had lower levels of IgE antibody, prevalence of positive skin prick test responses to house dust mite, and lower incidence of wheezing episodes. Follow-up is awaited. 

Sporik R, Holgate ST, Platts-Mills TAE, Cogswell JJ Exposure to house dust mite allergy (Derp 1) and the development of asthma in childhood. N Engl J Med 1990 323 502—507. (Ila)... 

Boner AL, Niero E, Antolini I, Valetta EA Pulmonary function and bronchial hyperreactivity in asthmatic children with house dust mite allergy during prolonged stay in the Italian Alps (Misurini 1756 m), Ann Allergy 1985 54 42-45, (lib)... 

Halken S, Niklassen U, Hansen LGH, Nielsen F, Host A, Osterballe O, et al Encasing of mattresses in children with asthma and house dust mite allergy (abstract). J Allergy Clin Immunol 1997 99 S320. (Ib)... 

Sakaguchi M., Inouye S., Yasueda H., Irie T., Yoshizawa S. and Shida T. (1989) Measurement of allergens associated with dust mite allergy, II. Concentrations of airborne mite allergens (Der I and Der II) in the house. Int. Arch. Allergy Appl. Immunol., 90, 190-193. 

Murray AB, Ferguson AC (1993) Dust-free bedrooms in the treatment of asthmatic children with house dust or dust mite allergy a controlled trial. Pediatrics 71 3 418-422. 

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