Food, drug, insect sting allergy, and anaphylaxisSensitization to Hymenoptera venoms is common, but systemic sting reactions are rare
Section snippets
Subjects
Subjects who tolerated previous Hymenoptera field stings without an SSR were initially screened for sIgE to Hymenoptera venom. Subjects with detectable sIgE to at least 1 Hymenoptera venom who met all other inclusion and exclusion criteria (see Table E1 in this article's Online Repository at www.jacionline.org) were asked to participate in the study. Finally, 110 subjects were enrolled. After a complete health check, including physical examinations, laboratory tests, spirometry, and
History and demographic data
Sixteen of 110 subjects refused sting challenges. Of 94 included subjects, 44 (46.8%) were male, and 50 (53.2%) were female. Median age was 29.0 (25% to 75% percentile, 24.0-40.3 years). Forty-eight (51.1%) were considered to have an atopic predisposition, and 27 (28.7%) reported previous LLRs caused by Hymenoptera stings.
Outcome of sting challenges
Finally, 131 sting challenges with bees, wasps, or both were performed in 94 subjects. Forty-one were stung by a bee, 16 by a wasp, and 37 by both a bee and a wasp. Only 6
Discussion
Positive test results to Hymenoptera venom despite a negative history are a well-known phenomenon in the general population. In older studies with IgE determination on the RAST platform, 27.1% were reported to have sIgE to Hymenoptera venoms,4 and using the refined fluorescence enzyme assay (ImmunoCAP), 40.7% had detectable sIgE to any Hymenoptera venom.5 In the initial phase of this study, 44.1% of all screened subjects had positive results. This rate of sensitization is quite high and cannot
References (26)
- et al.
Antibody binding to venom carbohydrates is a frequent cause for double positivity to honeybee and yellow jacket venom in patients with stinging-insect allergy
J Allergy Clin Immunol
(2001) - et al.
Added value of IgE detection to rApi m 1 and rVes v 5 in patients with Hymenoptera venom allergy
J Allergy Clin Immunol
(2011) - et al.
Low sensitivity of commercially available rApi m 1 for diagnosis of honeybee venom allergy
J Allergy Clin Immunol
(2011) - et al.
Detection of IgE to recombinant Api m 1 and rVes v 5 is valuable but not sufficient to distinguish bee from wasp venom allergy
J Allergy Clin Immunol
(2011) - et al.
Ves v 5 can establish the diagnosis in patients without detectable specific IgE to wasp venom and a possible north-south difference in Api m 1 sensitization in Europe
J Allergy Clin Immunol
(2012) - et al.
The value of an in-hospital insect sting challenge as a criterion for application or omission of venom immunotherapy
J Allergy Clin Immunol
(1996) - et al.
Evaluation of Hymenoptera-sting sensitivity with deliberate sting challenges: inadequacy of present diagnostic methods
J Allergy Clin Immunol
(1982) - et al.
Discontinuing venom immunotherapy: outcome after five years
J Allergy Clin Immunol
(1996) - et al.
The natural history and epidemiology of insect venom allergy: clinical implications
Clin Exp Allergy
(2009) - et al.
Diagnosis of Hymenoptera venom allergy
Allergy
(2005)
Prevalence of Hymenoptera venom allergy and poor adherence to immunotherapy in Austria
Allergy
IgE antibodies to Hymenoptera venoms in the serum are common in the general population and are related to indications of atopy
Allergy
Asymptomatic sensitization to Hymenoptera venom is related to total immunoglobulin E levels
Int Arch Allergy Immunol
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Supported by a grant from the Austrian Society for Dermatology and Venereology.
Disclosure of potential conflict of interest: G. J. Sturm has received research support from OEGDV and has received lecture fees from ALK-Abelló. C. Schuster has received lecture fees from the Austrian Workers' Compensation Board and ALK-Abelló. The rest of the authors declare that they have no relevant conflicts of interest.