Sublingual immunotherapy: A good choice for all forms of birch pollen allergy

Introduction. High prevalence of hypersensitivity to birch pollen significantly reduces the quality of life of affected individuals. Control of the simultaneous manifestation of allergic rhinitis and/or asthma and birch-apple allergy syndrome is particularly challenging. Opinions regarding the effects of allergen immunotherapy (AIT) on the control of birch-apple allergy syndrome are divided. Case outline. We present a female patient with poorly controlled allergic rhinitis and asthma due to hypersensitivity to birch pollen and allergy to apples, in whom sublingual immunotherapy (SLIT) with an oral lyophilizate of birch pollen was administered. Nine months of SLIT, added to pharmacological therapy, led to good control of allergic rhinitis and asthma and to the development of apple tolerance. Conclusion. The favorable outcome of SLIT in controlling respiratory allergies and inducing apple tolerance suggests that it may be a beneficial therapeutic option for the management of all clinical manifestations of birch pollen allergy.