Immunotherapy?

[Boysmum]

Hi. My son is 9 and has progressed from childhood eczema to food allergies and now to allergic rhinitis. He has confirmed allergy to house dust mites, tree pollen and grass pollen for which he takes Avamys every day and cetirizine. The Avamys does keeps his nose clear enough for him to breath through but it is still reasonably congested. I really fear that he will go on to develop asthma and so my question is, should we be considering immunotherapy for him? I am uncomfortable with idea of using a nasal spray indefinitely considering his young age and wonder if immunotherapy might benefit him?

Many thanks.

[Dr Joanna Lukawska]

Hi
As a mother of 2 young chidren I appreciate your concern.
I only work with adults and would be very happy for Adam or Helen (who are both paediatricians) to qualify my post, however the background of atopic dermatitis, food allergies and rhinitis makes your child likely to develop asthma in the future.
To date immunotherapy is the only treatment that has a disease modifying properties and can change natural course of allergic disease and might even halt progression from rhinitis to asthma. Your son is polysensitized (has allergies to more than one allergen), which makes immunotherapy more complicated and prolonged. In a similar adult who fulfilled all our criteria, immunotherapy would be a reasonable course of action.

I am sure the paediatricians will wish to add to this.

Best wishes