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Table 5 WAO Grading system for SLIT local adverse events

From: Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Symptom/sign (see Table1) Grade 1 – Mild Grade 2 – Moderate Grade 3 - Severe Unknown severity
Pruritus/swelling of mouth, tongue or lip Not troublesome Troublesome • Grade 2 The treatment is discontinued but there is no subjective and/or objective description of the severity from the patient/physician
Throat irritation AND OR AND
Nausea No symptomatic treatment required Requires symptomatic treatment • SLIT discontinued because of local side effects
Abdominal pain AND AND  
Vomiting No discontinuation of SLIT because of local side effects No discontinuation of SLIT because of local side effects  
Diarrhea
Heartburn
Uvular oedema
Each local adverse event can be early (<30 minutes) or delayed
  1. From [76]. Reprinted with permission from Elsevier.