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Adrenal insufficiency and allergy immunotherapy

Question:

7/22/2020
Is there any contraindication in starting allergen immunotherapy in patient with adrenal insufficiency? Would there be an issue if a patient was to develop systemic reaction and the adrenal gland is not making appropriate levels of hormones?

Answer:

It is important to understand the etiology of adrenal insufficiency. For example, is it secondary to corticosteroid use due to severe, uncontrolled asthma, which would be a contraindication to IT? However, if this is not the case, there should not be an issue with response to epinephrine in the case of systemic reactions.

I hope this is helpful.

Regards,
Daniel J. Jackson, MD, FAAAAI