Place de la désensibilisation spécifique dans la prise en charge d'une allergie croisée

Specific immunotherapy (IT) might be considered in patients with cross allergy in two types of clinical settings. The first one concern patients with food allergy related to pollen allergy particularly birch allergy. In this case careful analysis of the literature doesn't permit to validate an efficacy of IT on food allergy symptoms. Rapid improvement in knowledge about immunologic mechanisms responsible of such syndrome and progress in allergen extract engineering should rapidly lead to significant changes in this situation the next forthcoming years. On the other hand there is no indication that IT is deleterious in-patient with food allergy related to pollen sensitizations. So, in such patients IT remains indicated on the basis of nasal and or respiratory symptoms. The second one-concern patients with mite allergy and food allergy to shrimp or other invertebrate foods. In this case the literature is sparse and confusing. However, due to report of some case of severe reaction, it seems reasonable to avoid IT in patients with mite allergy and previous symptoms of food allergy to shrimp or other related food.