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Immunotherapie: effectiviteit en toepasbaarheid in de kindergeneeskunde

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Tijdschrift voor kindergeneeskunde

Summary

In this review an overview is presented of the literature concerning indications, contraindications, effectiveness and safety of immunotherapy in children. Immunotherapy is effective and indicated in children with pollinosis and mild to moderate asthma due to house dust mite or cat allergy. Life-threatening anaphylaxis due to insect venom allergy is an absolute indication for venom immunotherapy. Immunotherapy is less effective in children with multiple sensitizations, in this case optimal sanation and medical treatment are indicated. Immunotherapy should be initiated and evaluated by a specialist trained to treat atopic children. When immunotherapy is administered to children during the early phase of atopic disease it may modify the natural course, i.e. prevent new sensitizations and the development of asthma. In the future, other routes (nasal, sublingual), more acceptable for young children, will be indicated in selected patients.

Samenvatting

In dit artikel wordt een overzicht gegeven van de beschikbare literatuurgegevens aangaande de toepasbaarheid van immunotherapie in de kindergeneeskunde. Immunotherapie is zinvol bij kinderen met hooikoorts of mild tot matig astma met huisstofmijtallergie of katallergie en absoluut geïndiceerd bij levensbedreigende anafylaxie voor insectengif (wesp en bij). Er is geen plaats voor immunotherapie bij de behandeling van kinderen met astma met multipele allergieën: in dergelijke gevallen dient optimale behandeling plaats te vinden met sanering en farmacotherapie. Om veiligheidsredenen dienen de indicatie en uitvoering van immunotherapie te geschieden bij een specialist die ervaren is in de specifieke allergologische problematiek. Wat betreft de preventieve werking van immunotherapie zijn de schaarse voorlopige resultaten hoopgevend. Wellicht dient deze preventie in de toekomst uitgevoerd te worden op jongere leeftijd en met een ‘kindvriendelijker’ toedieningsvorm (nasaal of sublinguaal).

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    H. de Groot

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  1. H. de Groot
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H. de Groot, allergoloog, afd. Allergologie, Academisch Ziekenhuis Rotterdam, Postbus 2040, 3000 ca Rotterdam.

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de Groot, H. Immunotherapie: effectiviteit en toepasbaarheid in de kindergeneeskunde. KIND 68, 183–188 (2000). https://doi.org/10.1007/BF03061306

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