Comparison of Venom and Whole-Body Rast and Intradermal Testing in Vespid-Sensitive Patients

Meriney, David; Nall, Thomas; Wallace, Dana; Rosenzweig, David Y.; Goel, Zarina; Grieco, Michael H.

doi:10.1159/000232547

Cited by 5 publications

(2 citation statements)

References 8 publications

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“…In patients with a negative prick test it is therefore recommended to confirm this in the intradermal test. According to a number of studies, the sensitivity of intradermal testing may be estimated at about 90% or higher for a 1 μ g/ml concentration (108–112). The specificity of skin tests with Hymenoptera venoms is difficult to define, because exposed patients who never developed a systemic reaction may have been sensitized following their last sting.…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis of Hymenoptera venom allergy

Bilò¹,

Ruëff

Mosbech³

et al. 2005

Allergy

505

439

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The first EAACI position paper on immunotherapy with Hymenoptera venoms was published in 1987 (1). Six years later a revised version appeared (2). As then many papers on the diagnosis and treatment of Hymenoptera venom allergy have been published, making a review of the last EAACI position paper necessary. This paper focuses on Hymenoptera venom allergy, as allergic reactions caused by stings of insects other than Hymenoptera are rare and standardized extracts for the diagnosis and treatment of allergic reactions to nonHymenoptera insects are not available (3). TaxonomyMost authors follow the Chinery classification (4), although over the last few years a few minor changes have been introduced. Aculeatae are a suborder of Hymenoptera (Fig. 1).The family Apidae consists of the honeybees (Apis mellifera) who are brown in color and moderately hairy and the bumblebees (Genus Bombus) which are bigger than honeybees, much more hairy and characterized by distinct yellow or white bands on their abdomen. Vespidae are divided into the Vespinae and Polistinae subfamilies, with differences at the junction of the thorax and abdomen. Vespinae have a truncated junction while Polistinae are more oval in shape. Vespidae are almost hairless and have black and yellow striped abdomens.Vespula, Dolichovespula and Vespa make up the three genera of the Vespinae. Vespula (called wasps in Europe, yellow jackets in the USA) are the most important species in Europe. The Vespula spp. (V. germanica and The purpose of diagnostic procedure is to classify a sting reaction by history, identify the underlying pathogenetic mechanism, and identify the offending insect. Diagnosis of Hymenoptera venom allergy thus forms the basis for the treatment. In the central and northern Europe vespid (mainly Vespula spp.) and honeybee stings are the most prevalent, whereas in the Mediterranean area stings from Polistes and Vespula are more frequent than honeybee stings; bumblebee stings are rare throughout Europe and more of an occupational hazard. Several major allergens, usually glycoproteins with a molecular weight of 10-50 kDa, have been identified in venoms of bees, vespids. and ants. The sequences and structures of the majority of venom allergens have been determined and several have been expressed in recombinant form. A particular problem in the field of cross-reactivity are specific immunoglobulin E (IgE) antibodies directed against carbohydrate epitopes, which may induce multiple positive test results (skin test, in vitro tests) of still unknown clinical significance. Venom hypersensitivity may be mediated by immunologic mechanisms (IgE-mediated or non-IgE-mediated venom allergy) but also by nonimmunologic mechanisms. Reactions to Hymenoptera stings are classified into normal local reactions, large local reactions, systemic toxic reactions, systemic anaphylactic reactions, and unusual reactions. For most venom-allergic patients an anaphylactic reaction after a sting is very traumatic event, resulting in an altered health-related quality of life. Risk f...

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Section: Diagnosismentioning

confidence: 99%

Diagnosis of Hymenoptera venom allergy

Bilò¹,

Ruëff

Mosbech³

et al. 2005

Allergy

505

439

View full text Add to dashboard Cite

show abstract

“…Systemic allergic reactions to hymenoptera stings occur worldwide and severe anaphylaxis as a result of such stings is thought to cause more than 40 fatalities a year in the United States [ 1] and near 100 in Europe [ 2]. In the late 1970s diagnosis and treatment of this allergy were greatly improved by the introduction of hymenoptera venoms instead of the formerly used hymenoptera whole body extracts (WBE): in a number of studies [ 3–6] venoms were found to be highly superior to WBE in skin testing. Other authors observed a close association between a history of systemic sting reactions and the presence of venom specific serum IgE antibodies [ 7, 8].…”

Section: Indications For Venom Immunotherapy [According To 17]mentioning

confidence: 99%