Anaphylactic shock during immunotherapy in asthma: An eleven-years old boy with asthma and allergy to early flowering plants and grass pollen was started on immunotherapy in September. After three months of treatment with weekly increasing doses, the injection site was itchy for the first time. After one of the next injections the boy complained about pruritus in the entire body, eyelid swelling, a single episode of vomiting and slightly wheezing respiration. After consultation with the university hospital, the dose was halved and subsequently, after no further local reactions occurred, the dose was increased again using premedication with cetirizine (e.g. ZYRTEC). Swelling occurred occasionally at the injection site. After seven months, the highest dose was reached. Two months later, the child suffered from generalised pruritus, cold clammy skin, swelling of the eyelids, dyspnoea and hypotension a few minutes after administration. The boy was placed in shock position, given inhaled beta-sympathomimetics and prednisolone i.v. and recovered within a few hours (NETZWERK report 14.134). The event emphasises the risk of immunotherapy particularly for asthma patients. Severe allergic reactions must be anticipated at any time of treatment. On the other hand, the clinical benefit of immunotherapy remains controversial in asthma (a-t 2006; 37: 63-5).