Hymenoptera venom allergy in a single-center Israeli cohort: Clinical and laboratory characteristics

Hershko, Alon Y.; Shaharabani, Noa; Rosman, Yossi; Meir‐Shafrir, Keren; Lachover‐Roth, Idit; Engler, Anat Cohen; Mekori, Yoseph A.; Confino‐Cohen, Ronit

doi:10.1016/j.jaip.2019.05.003

Cited by 3 publications

(5 citation statements)

References 8 publications

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“…In this work, we report a MCD rate among HVA patients of 0.097% in the US population. While this rate cannot be statistically compared directly to the European or Israeli reports (7,13) because the current estimate encompasses a data set of millions versus prior reports involving hundreds patients, this reported rate is qualitatively lower than prior reports by over an order of magnitude. One explanation for the higher previously reported rate could be that prior studies occurred mainly within referral centers for mastocytosis and may have carried a selection bias.…”

Section: Discussionmentioning

confidence: 62%

“…Further, one study suggests that patients with severe hypotension and normal basal tryptase values have rates of MCD up to 75% (21). However, a recent publication from Israel demonstrated a MCD rate of 3.8% (or 3,800 per 100,000) amongst HVA patients (13), lower than the figures cited in European data. The rate, to our knowledge, has not been reported in a US population.…”

Section: Discussionmentioning

confidence: 86%

“…A recent single-center study of 159 patients from Israel found a lower rate of tryptase elevation and MC disease when compared to European data (3.8% as compared to 10-15.9%), suggesting geographic differences in co-occurrence of MCD and venom allergy may exist. (13). The rate of clonal MCD in the US HVA population remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of mastocytosis and Hymenoptera venom allergy in the United States

Schuler

Volertas

Khokhar

et al. 2021

Journal of Allergy and Clinical Immunology

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Prevalence of mastocytosis and Hymenoptera venom allergy in the United States

Schuler

Volertas

Khokhar

et al. 2021

Journal of Allergy and Clinical Immunology

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“…23 The reported prevalence of SM in the general population ranges from 10 to 17.2 per 100.000 inhabitants and is far higher among patients with HVA, with reported rates varying between reports and by geographic area (1.8% in the US, 3.8% in Israel, and 1-7.9% in European cohorts). [24][25][26][27][28] According to the 2016 WHO classification, a diagnosis of SM is made if one major and one minor or three minor criteria are met; however, discoveries over the past few years have resulted in a push towards an updated set of diagnostic criteria (see Table 1). 23,29 In addition to the established disease subsets mentioned above, two distinct entities of interest have recently been identified; namely, monoclonal mast cell activation syndrome (MMAS) and bone marrow mastocytosis (BMM).…”

Section: Key Messagesmentioning

confidence: 99%

Clonal mast cell disorders and hereditary α‐tryptasemia as risk factors for anaphylaxis

Kačar

Rijavec

Šelb

et al. 2023

Clin Experimental Allergy

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The association between Hymenoptera venom‐triggered anaphylaxis (HVA) and clonal mast cell‐related disorders (cMCD) has been known for decades. However, recent breakthroughs in peripheral blood screening for KIT p.D816V missense variant have revealed the true extent of this clinical association whilst adding to our understanding of the underlying aetiology. Thus, recent large studies highlighted the presence of KIT p.D816V among 18.2% and 23% of patients with severe Hymenoptera venom‐triggered anaphylaxis. A significant proportion of those patients have normal serum basal tryptase (BST) levels, with no cutaneous findings such as urticaria pigmentosa or other systemic findings such as organomegaly that would have suggested the presence of cMCD. These findings of an increased prevalence suggest that the impact of cMCD on anaphylaxis could be clinically underestimated and that the leading question for clinicians could be changed from ‘how many patients with cMCD have anaphylaxis?’ to ‘how many patients with anaphylaxis have cMCD?’. The discovery of hereditary α‐tryptasemia (HαT)—a genetic trait caused by an increased copy number of the Tryptase Alpha/Beta 1 (TPSAB1) gene‐, first described in 2016, is now known to underlie the majority of cases of elevated BST outside of cMCD and chronic kidney disease. HαT is the first common heritable genetic modifier of anaphylaxis described, and it is associated with increased risk for severe HVA (relative risk = 2.0), idiopathic anaphylaxis, and an increased prevalence of anaphylaxis in patients with cMCD, possibly due to the unique activity profile of α/β ‐tryptase heterotetramers that may potentiate immediate hypersensitivity reaction severity. Our narrative review aims to highlight recent research to have increased our understanding of cMCD and HαT, through recent lessons learned from studying their association with HVA. Additionally, we examined the studies of mast cell‐related disorders in food and drug allergy in an effort to determine whether one should also consider cMCD and/or HαT in cases of severe anaphylaxis triggered by food or drugs.

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“…(2019), je väčšina detských pacientov alergická na bodnutie jedom včely (88,7 % pacientov) v porovnaní s jedom osy (10,7 % pacientov). (7) Získané údaje sme porovnali s našou štúdiou, kde sme taktiež zaznamenali častejší výskyt alergie na jed včely ako na jed osy. Priemerný vek prvej reakcie našich pacientov bol 11 ± 4,37 rokov a v celkovom súbore bolo viacej chlapcov ako dievčat.…”

Section: Diskusiaunclassified

Safety and changes in selected laboratory parameters in children with hymenoptera venom allergy treated with venom immunotherapy

Kapustová,

Bánovčin,

Kapustová

et al. 2023

Czech-Slovak Pediatrics

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Bezpečnosť a zmeny vybraných laboratórnych parametrov u detí s alergiou na jed blanokrídleho hmyzu liečených venómovou imunoterapiou úvod: Alergia na jed blanokrídleho hmyzu je druhou najčastejšou príčinou anafylaxie detského veku. V súčasnosti jediná kauzálna terapia, ktorá môže navodiť toleranciu, je venómová imunoterapia (VIT). ciele: V našej práci sme sa zamerali na analýzu vybraných klinických a laboratórnych charakteristík v skupine pediatrických pacientov s alergiou na jed blanokrídleho hmyzu liečených VIT.Materiál a metódy: Vytvorili sme prospektívnu štúdiu, do ktorej bolo postupne zaradených 20 detských pacientov (13 chlapcov, 7 dievčat), ktorí spĺňali indikačné kritéria pre VIT. Dáta boli zberané od roku 2015 do roku 2022. Definovali sme základnú charakteristiku súboru, zamerali sme sa na celkovú toleranciu liečby u pediatrických pacientov a výskyt vedľajších účinkov počas podávania VIT, taktiež sme vykonali odber krvi na stanovanie dynamiky laboratórnych imunologických parametrov v presne stanovených časových intervaloch. výsledky: Priemerný vek bol 11 ± 4,37 rokov, pričom priemerný vek prvej systémovej reakcie po bodnutí bol 9,15 ± 3,58 rokov. Z 20 zaradených pacientov bolo 14 alergických na jed včely a 6 na jed osy. VIT bola priemerne začatá vo veku 10 ± 3,86 rokov, z toho 2 pacienti ju začali ešte pred dovŕšením piateho roku života. Medzi najčastejšie zastúpené klinické prejavy systémovej reakcie v našom súbore patrili angioedém tváre (70 %), dyspnoe (65 %), urtikária (55 %) a celotelový pruritus (45 %). Výskyt vedľajších príhod po VIT sme najčastejšie pozorovali počas úvodnej fázy podávania v zmysle lokálnych reakcií, pričom u žiadneho pacienta nedošlo k rozvoju systémovej reakcie. Prirodzená reexpozícia počas VIT sa vyskytla u 25 % pacientov, pričom u žiadneho sa nerozvinula systémová reakcia. V priebehu VIT sme zaznamenali aj dynamické zmeny jednotlivých hodnotených laboratórnych parametrov s postupným poklesom špecifických IgE proti extraktu a alergénovým komponentom hmyzieho jedu a vzostup špecifických IgG4 proti alergénovému extraktu.Záver: Alergiu na jed blanokrídleho hmyzu radíme medzi závažný až život ohrozujúci stav, pričom v súčasnosti jediná možná terapia, ktorou môžeme predchádzať vzniku systémovej reakcie a zlepšiť kvalitu života pacientom je VIT. U detských pacientov je udávaná vyššia účinnosť VIT a taktiež nižšie riziko zlyhania liečby. Naše skúsenosti dokladujú účinnosť aj bezpečnosť VIT v detskom veku a zároveň potvrdzujú pozitívne zmeny v laboratórnych parametroch naznačujúce indukciu imunitnej tolerancie.

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Hymenoptera venom allergy in a single-center Israeli cohort: Clinical and laboratory characteristics

Cited by 3 publications

References 8 publications

Prevalence of mastocytosis and Hymenoptera venom allergy in the United States

Prevalence of mastocytosis and Hymenoptera venom allergy in the United States

Clonal mast cell disorders and hereditary α‐tryptasemia as risk factors for anaphylaxis

Safety and changes in selected laboratory parameters in children with hymenoptera venom allergy treated with venom immunotherapy

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