The treatment of allergic rhinitis with immunotherapy: a review of 1,000 cases.

We conducted a 10-year retrospective chart review of 1,000 immunotherapy-treated patients to evaluate the efficacy and safety of serial dilution quantitative intradermal testing in the management of allergic rhinitis. Three months after the initiation of immunotherapy, these patients had been assessed to ascertain whether or not they had experienced any overall improvement in their initial symptoms. Also included in this evaluation were determinations of each patient's use of medications as well as the incidence of adverse reactions to treatment and recurrent sinus infections. We found that 860 patients had achieved complete relief of their symptoms and required no other treatment; the remaining 140 patients experienced a partial improvement and continued to use pharmacotherapy to control breakthrough symptoms. During skin testing, only one patient experienced a systemic reaction, which responded to subcutaneous epinephrine. There were no deaths. We conclude that serial dilution quantitative intradermal testing is safe and that quantification of skin reactivity in evaluating and treating allergic rhinitis with immunotherapy is completely effective in the vast majority of patients.