Anaphylactic Reactions After Discontinuation of Hymenoptera Venom Immunotherapy: A Clonal Mast Cell Disorder Should Be Suspected

Bonadonna, Patrizia; Zanotti, Roberta; Pagani, Mauro; Bonifacio, Massimiliano; Scaffidi, Luigi; Olivieri, Elisa; Franchini, Maurizio; Reccardini, Federico; Costantino, Maria Teresa; Roncallo, Chiara; Melato, Mauro; Boni, Elisa; Rizzini, Fabio Lodi; Bilò, Maria Beatrice; Marcarelli, Anna Rosaria; Passalacqua, Giovanni

doi:10.1016/j.jaip.2017.11.025

Cited by 58 publications

(31 citation statements)

References 26 publications

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“…A recent study in a selected population indicated that mastocytosis should be considered in patients who experience severe reactions at re-sting after discontinuation of VIT. On this basis, patients with mastocytosis and hymenoptera venom allergy should receive lifelong VIT [203].…”

Section: High Tryptase Valuesmentioning

confidence: 99%

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Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice

Bilò

Pravettoni

Bignardi

et al. 2019

J Investig Allergol Clin Immunol

115

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Hymenoptera venom allergy is an epidemiologically underestimated condition representing an important cause of morbidity worldwide. Preventing future allergic reactions in patients who have developed a systemic reaction is based on the correct management of emergency followed by a correct diagnosis, prescription of adrenaline autoinjectors and, where indicated, specific venom immunotherapy (VIT). Some epidemiological studies highlight the poor knowledge of this disease and the frequent inadequacy of its management. Moreover, they emphasize the importance of such a life-saving treatment as specific immunotherapy. The availability of high quality Hymenoptera venom extracts for diagnostic and therapeutic use has dramatically improved the prognosis and the quality of life of allergic patients. The subcutaneous VIT represents the most effective form of immunotherapy with allergen presently available, with a carry-over effect lasting up to several years after its interruption. This report on the management of children and adults allergic to Hymenoptera venom was drawn up by a panel of Italian experts. The main objective of this consensus is to review the scientific evidences related to diagnosis, therapy and management of patients allergic to Hymenoptera venom and is aimed to improve the knowledge about this disease and promote good clinical practices. Practical suggestions for a correct diagnosis, prescription of emergency therapy and immunotherapy, as well as strategies for taking care of patients´ management are included.

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Section: High Tryptase Valuesmentioning

confidence: 99%

“…Given reports of life-threatening and even fatal reactions to hymenoptera stings after discontinuation of treatment, long-term VIT (probably lifelong) may be recommended [100,203]. Patients not adequately protected by the usual maintenance dose of 100 μg should have their dose increased to 200 μg [252].…”

Section: Mastocytosismentioning

confidence: 99%

Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice

Bilò

Pravettoni

Bignardi

et al. 2019

J Investig Allergol Clin Immunol

115

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“…In selected cases (i.e. very severe pre-treatment anaphylactic reactions, clonal mast cell disorders with history of SR) VIT should be continued lifelong (96).…”

Section: Specific Venom Immunotherapy (Vit)mentioning

confidence: 99%

Clinical aspects of hymenoptera venom allergy and venom immunotherapy

Bilò

Tontini

Martini

et al. 2019

Eur Ann Allergy Clin Immunol

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“…Seventeen publications, among which six were international guidelines, were identified from literature search, which were screened for identification of all possible statements/recommendations [3,[6][7][8][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Resultsmentioning

confidence: 99%

Development of a model care pathway for the management of Hymenoptera venom allergy: evidence-based key interventions and indicators

Bilò

Corsi

Pravettoni

et al. 2020

Clin Transl Allergy

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Background: Hymenoptera venom allergy (HVA) is an underestimated condition representing an important cause of morbidity and mortality worldwide. Preventing future allergic reactions in patients who have already developed a systemic reaction is based on the correct management of the acute phase of the reaction followed by a correct diagnosis and, where indicated, prescription of adrenaline autoinjectors and VIT. A possible strategy to optimize care processes and to improve outcomes is the implementation of a Diagnostic and Therapeutic Care Pathways, also known as Integrated Care Pathways or Clinical Pathways (CPWs). The aim of the care pathway is to enhance the quality of care by improving risk-adjusted patient outcomes, promoting patient safety, increasing patient satisfaction, and optimizing the use of resources. To our knowledge, currently in Italy as well as in Europe, there is no CPWs codified for the management of HVA patients. This paper describes the development of the clinical content of a care pathway for the management of HVA. Methods:The methodology applied is based on the eight step method to build the clinical content of an evidencebased care pathway suggested by Lodewijckx et al. Results:Three hundred and seventeen different clinical activities were extracted from the selected literature. The expert panel was involved in their evaluation, expressing a judgment of relevance through the Delphi study. As a result, 126 clinical activities were appraised to be valid and feasible. The final recommendations (126) were translated into 123 key interventions. Six indicators were produced by the clinical activities. Conclusion:A set of 123 key interventions and of six process indicators were found to be appropriate for the development and standardization of the clinical content of the Hymenoptera venom allergy care pathway.

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Anaphylactic Reactions After Discontinuation of Hymenoptera Venom Immunotherapy: A Clonal Mast Cell Disorder Should Be Suspected

Cited by 58 publications

References 26 publications

Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice

Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice

Clinical aspects of hymenoptera venom allergy and venom immunotherapy

Development of a model care pathway for the management of Hymenoptera venom allergy: evidence-based key interventions and indicators

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