Autoimmune disease induced by allergen specific immunotherapy.

WOW! Yes, I did them for a year and they didn't help at all back in 1993. I had sinus surgery in 1994 which is not a cureall, but, it helped. I wasn't diagnosed with autoimmune disease until 2 years later. I will say this, in retrospect, my immune system worsensed after allergy shots and I caught everything when I worked in the healthfield. I did not make the connection until your post. Thank you for posting this. I am so sorry that you are battling so much. God Bless You.

@carlosroman34. Welcome to Mayo Clinic Connect. You listed some articles that would make interesting reading. May I ask what medical or scientific journals you found them in?
Are you currently receiving treatment for your relapsing polychondritis?
I hope you can find some answers here once members read your discussion!

Yes! let me share with you.

"Manifestation of rheumatoid arthritis during subcutaneous allergen-specific immunotherapy with bee venom"

Journal of allergy and clinical immunology

Scleroderma related to specific immunotherapy. A report of a case Revista alergia México CMICA CONICA

Pemphigoid reaction by specific allergen immunotherapy: An unusual adverse reaction
Margarita Tomás-Pérez1 * Revista alergia México

Springer link: Specific immunotherapy-induced Sjögren’s syndrome N. Turkcapar

Allergen-specific immunotherapy and risk of autoimmune disease Linneberg, Allan; Madsen, Flemming; Skaaby, Tea Current Opinion in Allergy and Clinical Immunology

View Translation

There are undoubtedly times when specific, accepted medical treatments have the unfortunate effect of causing injury to a few of those being treated. I'm sorry this happened to you. But overall, studies indicate that targeted allergy treatments lessen the occurrence of autoimmune disease in allergic individuals.

This retrospective study, which included Andrejz Bozek as an author, seems to say the opposite, that autoimmune disease incidence is less in SCIT patients:
"Additionally, patients with allergies (group A, B, C) had a decreased risk of developing any of the analyzed autoimmune diseases, HR =0.76 (95% CI: 0.62–0.88), compared with the other subjects (group D). There were no significant differences between groups A, B and C in this regard." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054798/

From Allan Linneberg: "During the 10-year study period (1997-2006), a total of 18,841 and 428,484 persons were followed in the SCIT and CAT groups, respectively. Receiving SCIT was associated with lower mortality (HR, 0.71; 95% CI, 0.62-0.81) and lower incidence of AMI (HR, 0.70; 95% CI, 0.52-0.93), IHD (HR, 0.88; 95% CI, 0.73-1.05), and autoimmune disease (HR, 0.86; 95% CI, 0.74-0.99)."
https://www.jacionline.org/article/S0091-6749(11)01452-7/fulltext

There is a repeated caution, however, in modern medical literature, which indicates that people with rheumatic autoimmune conditions are are not candidates for targeted immunotherapy (e.g. allergy shots)
https://pubmed.ncbi.nlm.nih.gov/35818067/

The other studies you shared are individual case studies, and I cannot find any follow-up larger studies indicating such situation occurs in large groups.

One other question I have - it seems like this happened to you over 20 years ago, and medicine has come a long way. Did you find any information to indicate this was a known issue prior to the articles in 2012? If not, do you think it is fair to accuse a doctor of medical negligence when following the standard of care for the time?

Sue

I personally spoke with Allan Linneberg and other allergists in Mexico after my situation happened and they ALL came to the conclusion that allergen-specific immunotherapy can induce autoimmune diseases (it is rare but it can occur).

With a prior evaluation (review the history, autoantibodies, etc., a situation like mine can be avoided)

Since the 80s, this situation began to be seen in various parts of the world. In 1989, the recommendation was made to evaluate people in terms of risk of self-immunity before starting SIT. My situation developed in 2002.

The negligence comes from the treatment of me (I was a 13-year-old boy) and my mother. This doctor never wanted to publish my case in the literature and I consider that an event like mine should be published.

His words were "if you are so interested, publish it yourself", and well here I am sharing my experience.

Those "individual cases" at the end of all are lives, lives that, like me, I know suffer.

Published cases indicate an overestimation of the true incidence of development of autoimmune diseases in people receiving SIT

I invite you to search forums for various autoimmune diseases and you will be able to find several stories like mine.

I only hope that this situation is not repeated and the doctors in charge of carrying out these treatments have a little caution, given the "delicate" nature of the subject in Linneberg's own words.

View Translation

Can you explain exactly what tests should be performed prior to beginning allergy shots to avoid the problem you have?
I know that people with beta-blockers, MAOI's rheumatoid arthritis and uncontrolled asthma are not candidates for these injections. So a comprehensive medical history is important. But I have been unable to find literature about blood tests that could be routinely performed in advance.
Would taking your medical history have led the allergist to avoid shots for you based on your known health conditions or family history?
Sue

In the published case "Manifestation of rheumatoid arthritis during subcutaneous allergen-specific immunotherapy" by Kamran Ghoreschi, MD it is mentioned:

However, the observation by Linneberg et al1 was focused on the overall incidence of AD and not on the actual coincidence of SCIT and AD during SCIT."

Our observation of 1 patient with SCIT and concomitant AD suggests that careful history and even autoantibody testing before SCIT might be helpful in selected patients to identify those at risk for AD during SCIT.

In general, the benefit/risk ratio in patients with venom allergy favors induction of SCIT, and further investigations will be necessary to be able to evaluate the risk for AD during SCIT.

For its part, another study titled Autoimmune thyroiditis detected during allergen-specific immunotherapy: a case report

A 14-year-old girl diagnosed with asthma who developed findings of autoimmune thyroiditis and goiter four months after SIT with grass pollen antigens is presented to emphasize the possibility of autoimmune disease development during the course of SIT and the need for further research about this coexistence. .

The reports indicate that a prior evaluation must be had for each person.

The negligence of this allergist is also partly due to the fact that since my childhood I had a significant health history and he knew it, and he simply started the immunotherapy without any prior evaluation.

We can see reviews of this allergist, named Guillerm, on Google and it seems that I have not been the only one who has treated him in a negligent manner.

I can quote you a review from a person in google:

"I took my baby for a checkup with him because I suspected an allergy. At first I received a lecture that my baby is sick because of me, and that I was "carbureting" too much. According to him, he checked my baby and told me he had an infection and prescribed an antibiotic. My baby had severe diarrhea two days later and the doctor just told me to stop the antibiotic. Without any follow-up from this doctor, I took my baby to a pediatrician and they confirmed that my baby does not have an infection and should never have been given antibiotics. This doctor is not qualified to see babies, please don't make the same mistake as me. Unfortunately, she tells me that my baby is not allergic and she didn't even do any tests."

More than a controversy, my main concern is to try to prevent this situation from continuing to happen, since in the end I have not been the only one who has gone through this, and one thing is certain, my illness began 20 years ago, but the people who suffer We suffer from an autoimmune disease day by day, my kidney function falls more every day until I wait for a transplant.

I believe that with a little caution on the part of allergists, tragedies like mine and those of other people can be avoided.

View Translation

I had allergy shots at age 30 to 33 for 3 years in the 1970s while living in Germany. They helped with my grass, tree, pollen allergies since. At age 73 I was diagnosed with PMR an auto immune disease. After all those years could it be connected to the allergy shots?

Makes you wonder doesn't it? I had never heard of this before until Carlosroman34 made the post. It's very interesting.

Hello, nice to meet you, what I have seen is that in most cases the autoimmune disease appears during the course of immunotherapy, however there are some cases where the disease develops some time later.

I attach the data of an article of 3 cases of sarcoidosis after SIT.

Sarcoidosis following specific immunotherapy: more than just coincidence?

DOI: 10.1157/13099093

View Translation