Sarah was a care-free, happy six-year-old who enjoyed playing outdoors and swimming with her brother. One of these care-free moments were cut short when Sarah was stung by a bee at her brother’s school fete. Her hand was swollen and resembled a tennis ball for two days straight, but the whole incident was made off as a mere inconvenience. Little did they know …

Sometime after her first bee sting, Sarah was playing on on jumping castle. Her path crossed with another bee, which also stung her. This time Sarah’s body reacted much more drastically. Her face turned red, and she was struggling to breathe, leaving her distressed mom with no other choice but to seek emergency treatment.

The danger of Sarah’s allergic reaction now was very real. It was clear that she would have to be very careful to avoid getting stung and have a plan in place should she ever get stung again.  Sarah’s mom decided to visit The Allergy Clinic to explore how immunotherapy might address her bee allergy.

The therapy entailed three months of weekly injections, followed by monthly injections for the remaining three years. And the proof was in the pudding when they went to the Kruger National Park, and Sarah was (once again!) stung by a bee. This time, they did not need to use her Epipen and the whole family was happy to see that the sacrifice of all those injections was worth it. After three years of injections, Sarah remains protected after stopping the immunotherapy.

Introducing immunotherapy and desensitisation

Immunotherapy and desensitisation have become common terms in the healthcare sector, but often our grasp on it remains vague. When a patient undergoes immunotherapy or desensitisation, we attempt to “retrain” the immune system to not react against a substance it usually perceives as foreign and dangerous, leading to anaphylaxis. The process involves giving micrograms of an allergen over an extended period. Your body then produces antibodies that block the allergic reaction, and we protect ourselves from what we are allergic to.

It’s important to note there is a difference between immunotherapy and desensitisation. With immunotherapy, the body can retain the memory of the new antibody pathway. We can eventually stop the treatment, leaving you protected like in Sarah’s case.

Immunotherapy is available in drops and injectable forms for environmental allergens such as cats, dogs, grass. This is successful in treating allergic rhinitis and giving better control of allergic asthma and recurrent airway infections. Bee venom immunotherapy is only available in injectable form.

Desensitisation is often temporary and used for medication allergies like Penicillin allergy and food allergies.

The role of an allergy doctor

Either of these treatments can be very successful when done by an experienced and trained allergy doctor in a controlled environment. This is because there always is a risk of a severe allergic reaction during either of these therapies. To address this risk, resuscitation equipment and expertise to use it must be available at all times.

When patients come to me to explore treatment options for their allergies, we will decide on a treatment protocol that suits their needs, lifestyle and international medical guidelines. In some instances, immunotherapy is the best option. And in some other cases, desensitisation is the best route to follow.

  • Don’t miss our article about oral immunotherapy, which is used to treat food allergies.
  • You can also read more about immunotherapy on the Allergy Foundation’s website
  • The purpose of this article is to raise awareness of allergies and the treatment options that are available for it. This article should by no means be used, or viewed, as a primary source for medical or other professional advice – please arrange for a personal consultation with your medical practitioner before taking any decisions that could affect the wellbeing of you or your loved ones. Read our medical disclaimer for more information.

    Marinda McDonald

    Dr Marinda McDonald has offered specialised treatments for allergies for most of her professional career. Read more about her on the home page of this website (allergydoc.co.za).

    1 Comment

    Oral immunotherapy: The pros, cons and risks | The Allergy Clinic · February 10, 2020 at 9:28 am

    […] my previous blog post, I explained the similarities and differences between immunotherapy and desensitisation. But to […]

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