In most affected persons, a Hymenoptera sting results in local itching and mild induration. There are some individuals, however, who additionally respond to a sting by developing sensitization manifested by the presence of venom-specific immunoglobulin E (IgE) antibodies (vsIgE) to various components of insect venoms (in honeybee venom, 12 allergens have been identified so far: Api m1 -Api m 12; in wasp venom, 5 allergens have been identified: Vesp v 1, V v 2, Vesp v 3, Vesp v5, and Ves v 6). 2 Venom sensitization is the key factor for but is not synonymous with venom allergy. Sensitization to Hymenoptera venoms may be asymptomatic (hypersensitivity not clinically relevant) or symptomatic defined as Hymenoptera--venom allergy (HVA). The asymptomatic sensitization is common and found in 9.3% to 40.7% of the general population and in 30% to 60% of beekeepers (which reflects the effect of exposition toThe occurrence of Hymenoptera-venom allergy Allergic reactions to insect bites result most frequently from stings of flying insects of the Hymenoptera order. From among over 100 000 species of Hymenoptera, the ones mainly responsible for sting reactions are usually honeybee (Apis mellifera) as well as wasps and hornets (eg, Vespula germanica, V. vulgaris, V. rufa, Vespae sp.). However, potential perpetrators of Hymenoptera allegry are diverse and vary with geography. In southern Europe, there are paper wasps (Polistinae subfamilies); in the United States, there are fire ants (Solenopsis invicta); and in Australia, there are Jack jumper ants (Myrmecia pilosula) that seem to cause more problems. A large number of Hymenoptera species, their ways of feeding, and their aggressive defense behavior result in as many as 56.6% to 94.5% of people experiencing at least 1 sting in their lives. ABSTRACTDuring their lifetime, 94.5% of people are stung by wasps, honeybees, hornets, or bumble-bees (order Hymenoptera). After a sting, most people show typical local symptoms, 5% to 15% develop local allergic reactions, and 3% to 8.9%-systemic allergic reactions (SARs), which may be potentially life-threatening in about 10% of them. In mild forms of Hymenoptera-venom allergy (HVA), the leading symptoms are urticaria and edema (grades I and II, respectively, according to the Mueller classification). Severe SARs are classified as grade III (respiratory symptoms) and IV (cardiovascular symptoms). Rare manifestations of HVA are Kounis syndrome and takotsubo cardiomyopathy. All patients after an SAR require standard (skin test, IgE, tryptase) or comprehensive (component diagnosis, basophil activation test) allergy testing. All patients with severe systemic symptoms (hypertension, disturbances in consciousness) should be tested for mastocytosis. Additionally, a relationship was found between the severity of HVA symptoms and intake of angiotensin-converting enzyme inhibitors (ACEIs). There is a similar concern, although less well-documented, about the use of β-blockers. Patients with HVA who have experienced a SAR are potential candidates for ...

The objective of our study was to evaluate the impact of sex and age on the prevalence of sensitization to inhalant allergens. The study was performed as a part of Polish Epidemiology of Allergic Diseases study, and data concerning citizens of Wroclaw were analyzed. The participants were divided into three age groups (6–7, 13–14, and 20–44 years) with a subdivision according to sex. We randomly selected 1409 individuals, 439 people complied; the complete set of tests was performed on 421 of them. We found that 37.7 % of the study population demonstrated sensitization to at least one of the allergens tested. Positive skin tests were found more frequently in males than in females (p = 0.003); among 6–7-year-old children, the sensitization was independent of sex (p = 0.26), while in two other groups, it was higher in males (p = 0.002 and p = 0.03, respectively). Clinically asymptomatic sensitization (AS) was found more often in females than in males (p = 0.04). The higher rate of AS in women was observed only in the two younger age groups, while in the 20–44-year-old group AS did not differ between the sexes (p = 0.72). Female sex hormones may contribute to a later change in the nature of sensitization from clinically asymptomatic to symptomatic. Further studies are needed to confirm the results of our study.

Background: Large local reaction to Hymenoptera stings is usually defined as a swelling >10 cm which lasts longer than 24 hours, sometimes associated with erythema, pruritus and blisters. Currently, the risk of subsequent systemic reactions after restings is considered low (2%-15%). Therefore, a diagnostic workup in case of large local reaction is often judged unnecessary, as well as adrenaline auto-injector and venom immunotherapy prescription. The aim of this study was to prospectively evaluate the outcome of re-stings in a real-world setting, in patients with a history of one previous large local reaction.

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