Medical Algorithms: Diagnosis and treatment of Hymenoptera venom allergy

Abstract

Diagnosis of Hymenoptera venom allergy (HVA) is straightforward in the majority of patients, but can be challenging in double positive and test negative patients. Test results sometimes can be confusing as patients with high skin test reactivity and high specific IgE (sIgE) levels are not at risk for severe systemic sting reactions (SSR), and conversely, patients with weakly positive or even negative tests can experience severe SSR. Venom immunotherapy (VIT) is safe, highly effective, and recommended in patients with moderate to severe SSR and in patients with SSR confined to generalized skin symptoms if quality of life is impaired.

Allergen Immunotherapy in Children User’s Guide

“…Component‐resolved diagnosis (CRD) was considered to significantly improve the diagnosis of insect venom allergy. However, it is still evolving and currently of limited use . The diagnostic tools in children are not different from those used in adults …”

“…Recommendations for venom immunotherapy ( VIT ) for children. VIT is recommended in children who suffered from systemic reactions exceeding generalized skin symptoms (adapted from Sturm et al …”

Apitoxin and Its Components against Cancer, Neurodegeneration and Rheumatoid Arthritis: Limitations and Possibilities

“…Small proteins and peptides Allergies against insect venoms are frequently observed, including anaphylactic reactions with potential fatal outcomes [6]. Major allergens in bee venom include phospholipase A2, melittin and hyaluronidase [6,7], which can lead to a variety of symptoms including mild (skin reactions, flushing, urticaria and angioedema), moderate (dizziness, dyspnea and nausea) and even severe reactions like anaphylactic shock, loss of consciousness and cardiac or respiratory arrest often accompanied with high mortality [8,9]. Allergies typically occur after the second exposure to the same or a closely related allergen.…”

Immunoterapia na jad owadów błonkoskrzydłych – kiedy i kogo kwalifikować do leczenia

“…Zidentyfikowanie owada znacznie ułatwia poprowadzenie dalszego postępowania. Kolejną istotną informacją są opisywane objawy pojawiające się kolejno po [11]. Testy hamowania IgE z ekstraktami całego jadu owadów błonkoskrzydłych mogą być stosowane w szczególnych przypadkach do wykrycia pierwotnego jadu uczulającego u chorych podwójnie dodatnich na jady bez alergenów markerowych.…”

“…Jeśli chodzi o panel alergenów jadu pszczelego, to jego czułość jest również niska i niemożliwe jest zdiagnozowanie lub wykluczenie alergii na jad pszczoły. Jednak pojedynczy dodatni wynik Api m 5 może wskazywać na reakcję krzyżową z jadem osy i wyklucza alergię na jad pszczoły [11].…”