Allergic reactions to insect stings: Results from a national survey of 10,000 junior high school children in Israel

Graif, Yael; Romano-Zelekha, Orly; Livne, Irit; Green, Manfred S.; Shohat, Tamy

doi:10.1016/j.jaci.2006.03.004

Cited by 50 publications

(52 citation statements)

References 31 publications

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“…As a result of spending more time outdoors leading to an increased risk of exposure to insect stings, a male predominance was present in our study population, as shown in previous childhood studies [5,6,7,18,19]. The upper limb was the most common area of stings in parallel with previous studies [20,21,22].…”

Section: Discussionsupporting

confidence: 85%

“…Results of a recent study on British beekeepers revealed female sex as a predisposing factor for severe SR [29]. There are relatively few studies in children, and their results did not establish gender as a risk factor for SR [6,7,19]. In our study, a higher percentage of girls had severe reactions when compared to boys (84.2 vs. 50.9%; p = 0.01), and results of multivariate logistic regression analysis revealed female sex as a significant risk factor for severe SR. To the best of our knowledge, it is a novel finding in children with insect venom allergy.…”

Section: Discussionmentioning

confidence: 99%

“…Severity and the prevalence of systemic reactions (SRs) are reported to be less common than in adults [4]. Epidemiological studies worldwide report a prevalence of SRs ranging from 0.34 to 6.5% in schoolchildren [5,6,7]. In Turkey, the lifetime cumulative sting prevalence and severe SR incidence in children aged 6–13 years was estimated to be 60.8 and 0.2%, respectively [8].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Features of Children with Venom Allergy and Risk Factors for Severe Systemic Reactions

Yavuz

Şahiner²,

Büyüktiryaki³

et al. 2012

Int Arch Allergy Immunol

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Background: Severe systemic reactions (SRs) to insect venom are rare in childhood and there are few data on this study population. The aim of our study is to analyze the clinical features and to document the risk factors for severe SRs in children with insect venom allergy. Methods: Children with SRs after Hymenoptera sting were analyzed. The diagnosis was based on medical history, skin tests and/or specific IgE testing. Results: Seventy-six children were included [57 boys (75%), mean age 9.8 ± 3.4 years]. The mean age of children at the time of SR was 8.3 ± 3.4 years. Reactions were accounted for Vespula (wasp) venom in 58 (76%) and Apis mellifera (bee) venom in 18 (24%) patients. Twenty-six percent of patients had aeroallergen sensitization and 33% had atopic disease, whereas 66% had experienced previous stings. The upper limb was the most frequent area of sting (43%), and the cutaneous system (99%) was the most frequent involved system. SRs occurred in 59% of patients. Multivariate logistic regression analysis revealed eosinophilia (>5%) [odds ratio (OR) 12.6; confidence interval (CI) 1.5–109.7; p = 0.022], female sex (OR 6.4; CI 1.5–26.9; p = 0.011) and accompanying atopic disease (OR 3.4; CI 1.2–12.3; p = 0.016) as significant risk factors for severe SRs. Ninety-seven percent of patients were admitted to the emergency department; however, epinephrine was used in only 46% of patients. Conclusions: There was a high frequency of hypersensitivity to wasp venom among the study population, and severe reactions were related to mild eosinophilia, female sex and concomitant atopic diseases. A better understanding of the risk factors may lead to effective utilization of health care sources in the future.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Features of Children with Venom Allergy and Risk Factors for Severe Systemic Reactions

Yavuz

Şahiner²,

Büyüktiryaki³

et al. 2012

Int Arch Allergy Immunol

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“…[8][9][10][11][12][13][14][15] While analyzing the data obtained from the latter investigations, it is important to consider gender in the context of other factors affecting the incidence of HVA, reflecting the degree of exposition, such as: age (child/adult), place of residence (industrialized/ rural areas), and sting rate (rarely/frequently).…”

Section: Gender and The Prevalence Of Insect Hypersensitivity Reactionsmentioning

confidence: 99%

“…14 In the majority of recent studies, however, women's HVA prevalence rate is viewed as similar to men's, with respect to the incidence of both LL and SYS reactions. [9][10][11][12][13] Comparable results estimating the prevalence of HVA as relatively equal were presented by three Spanish studies and a Polish one, performed on large populations living in industrialized urban areas of Europe. [8][9][10][11] Since the European investigations were conducted in one type of environment -industrial agglomerationstheir results seem to be clinically valid as the degree of exposition to stinging insects should be the same for women and men.…”

Section: Gender and The Prevalence Of Insect Hypersensitivity Reactionsmentioning

confidence: 99%

Sex-related clinical aspects in insect venom anaphylaxis

Nittner-Marszalska

Liebhart

Dor-Wojnarowska

2015

Int J Immunopathol Pharmacol

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Experimental studies, epidemiological data, and clinical observations suggest that the gender factor is involved in the development and manifestation of IgE-dependent allergic diseases. We intend to answer the question if sex-related factors may play a role in Hymenoptera venom allergy (HVA). In the majority of recent studies the frequency of HVA symptoms with respect to both LL and SYS reactions is similar for men and women, while proven sensitization to insect venom is less frequent in women. Studies assessing clinical reactivity in HVA indicate that male sex and vespid venom allergy are factors increasing the risk of severe allergic reactions. Regarding the risk of adverse events associated with gender in the course of venom immunotherapy (VIT), the results of two large EAACI multicenter studies are discordant. In the first study, women showed increased risk of VIT adverse events. In the latter, systemic allergic side effects were not associated with gender. Despite theoretical premises and certain clinical observations indicating an important role of estrogens in allergic diseases, their influence on stinging insects' venom hypersensitivity is not unequivocal and remains still open. Further studies on the safety of VIT in females seem to be advisable.

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