Intralymphatic immunotherapy
The patients were randomized into three groups receiving three doses at four-week intervals of 0.1 ml of birch pollen allergen on aluminum hydroxide (10,000 SQ-U/ml; ALK-Abelló, Hørsholm, Denmark) and/or 0.1 ml of 5-grass pollen allergen on aluminum hydroxide (10,000 SQ-U/ml; ALK-Abelló, Hørsholm, Denmark. 5-grass is a mix of equal amounts of SQ-U of Alopecurus pratensis (meadow foxtale), Dactylis glomerata (cocks’s foot), Festuca pratensis (meadow fescue),Lolium perenne (English ryegrass), and Phleum pratense(timothy). Each allergen dose was 1.000 SQ-U. A diluent from ALK was used as placebo. Thus the received two injections, one in each groin on three occasions. Patients were randomized in blocks of six, facilitated by Forum Östergötland. An unblinded nurse prepared and marked each syringe with a label providing randomization number, injection number and injection site. ILIT was administered by three clinicians (LA, PR, and UN). Ultrasound-led technique was used whereby a lymph node was punctured with a 27G (0.4 x 40 mm) needle. Histamine-1 blocker desloratadine tablet 5 mg was given 15 minutes prior to the injections.