Peer-reviewed veterinary case report
First report of angio-oedema subsequent to the administration of allergen specific sublingual immunotherapy for the management of equine hypersensitivity dermatitis.
- Journal:
- Veterinary dermatology
- Year:
- 2016
- Authors:
- Scholz, Fiona M et al.
- Affiliation:
- Animal Dermatology Clinic · Australia
- Species:
- horse
Plain-English summary
A seven-year-old warmblood mare was diagnosed with equine hypersensitivity dermatitis, a skin allergy condition. Her owner chose to try sublingual immunotherapy (SLIT), a method of allergy treatment that involves placing allergens under the tongue, instead of the more common injection method. However, about a day and a half after starting SLIT, the mare experienced swelling around her eyes, trouble breathing, and stomach pain. After pausing the treatment and trying a weaker version of the SLIT, she developed swelling of her tongue, leading to the decision to stop SLIT altogether. When the horse was later given a different form of allergy treatment called subcutaneous immunotherapy (SCIT), she did not have any adverse reactions. This case highlights that while SLIT is a potential treatment, it can lead to unexpected side effects in horses.
Abstract
BACKGROUND: Sublingual immunotherapy (SLIT) offers an alternative mode of allergen delivery to subcutaneous immunotherapy (SCIT) with the aim of inducing immunological tolerance. Currently, there are no published reports regarding the efficacy or safety of SLIT in horses. HYPOTHESIS/OBJECTIVE: To describe the first case of several adverse events occurring in a horse subsequent to the repeat administration of SLIT. ANIMAL: A seven-year-old, warmblood mare with a confirmed diagnosis of equine hypersensitivity dermatitis (EHD). METHODS AND RESULTS: Immunotherapy was recommended for management of EHD. Due to the temperament of the horse, the owner elected to proceed with SLIT. Thirty six hours after commencing SLIT, the mare developed scleral oedema, moderate dyspnoea and abdominal discomfort. SLIT was withdrawn for 10 days and re instituted using a ten-fold dilution of the original vaccine. Localized oedema and swelling of the tongue developed within 12 h of administration. At this juncture, SLIT was withdrawn. The horse was rechallenged with the SLIT allergen vehicle, 50% glycerine and no adverse reactions occurred. SCIT was commenced using the same allergens and no adverse events occurred with repeated administration. CONCLUSIONS AND CLINICAL IMPORTANCE: To the best of the authors' knowledge, this is the first reported case of adverse reactions developing subsequent to the administration of SLIT for the management of EHD.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/27350603/