Demonstration of IgE and IgG antibodies against venoms in the blood of victims of fatal sting anaphylaxis

Hoffman, Donald R.; Wood, Catherine L.; Hudson, Page

doi:10.1016/0091-6749(83)90099-4

Cited by 35 publications

(15 citation statements)

References 7 publications

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“…While the estimated annual death rate from Hymenoptera sting anaphylaxis is quite small, these estimates are based on clinical data, complicated by the fact that in many areas ofthe country deaths will be attributed to 'natural causes', heart disease or other common diseases, based on the clinical judgement of coroners, who are frequently non-physicians. Verification of sting anaphylaxis is important on epidemiological grounds, and in a medicolegal sense, because it is a form of accidental death, rather than death due to natural causes [5]. It is thus a matter of great interest to gather data on the prevalence of anti-venom IgE antibodies in the sera of patients dying unexpectedly, and to compare these with estimates of such sensitivity in normal populations.…”

Section: Discussionmentioning

confidence: 99%

“…In a survey by Hoffman et al, IgE antibodies to several Hymenoptera venoms were measured in various patient populations [5]. All of eighipost-mortem sera from victims of fatal sting anaphylaxis contained elevated IgE antibodies to venoms.…”

Section: Discussionmentioning

confidence: 99%

“…In the last few years venom-specific IgE antibodies have been successM\y measMTed in sera from patients with insect-sting allergy [4][5][6][7][8], IgE antibody levels correlate qualitatively with venom skin-test results in these patients [8] and thus are useful in the diagnosis of venom allergy. Most recently, venom-specific IgE antibodies have been demonstrated in post-mortem blood samples obtained from a few people who died of sting anaphyiaxis [5,9]. Fatal insect sting anaphyiaxis can now be investigated by postmortem serum immunoassay so we have studied a series of post-mortem blood samples from a large number of people dying unexpectedly, in an effort to establish whether insect-sting anaphyiaxis should be more highly considered as a possible cause of unexpected death in an adult metropolitan population.…”

Section: Introductionmentioning

confidence: 99%

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Hymenoptera venom‐specific IgE antibodies in post‐mortem sera from victims of sudden, unexpected death

Schwartz

Sutheimer

Gauerke

et al. 1988

Clin Experimental Allergy

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Summary There have been reports of elevated venom‐specific IgE levels in post‐mortem sera from patients experiencing fatal Hymenoptera stings so we hypothesized that other cases of sudden death may be due to unrecognized sting anaphyiaxis. Of 94 sera obtained post mortem from subjects who died unexpectedly during the summer months, 22 (23%) contained elevated levels of IgE antibody to at least one insect venom. The causes of death as determined by autopsy did not differ significantly among patients with or without elevated IgE antibody levels. An identical percentage of seropositivity was noted in 48 post‐mortem sera from victims of sudden, unexpected death in the winter months. Conversely, only 6% of sera from 92 living blood donors contained elevated venom‐specific IgE antibodies. The appreciable incidence of elevated IgE antibodies in the post‐mortem groups suggests that sting anaphylaxis should be more highly considered as a possible cause of unexpected death.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hymenoptera venom‐specific IgE antibodies in post‐mortem sera from victims of sudden, unexpected death

Schwartz

Sutheimer

Gauerke

et al. 1988

Clin Experimental Allergy

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“…However care has to be taken with the interpretation of tryptase levels as elevation is not specific to an acute allergic reaction [425][426][427]. Testing for the presence of IgE antibodies to the suspected allergen may be used as a supplementary investigation [428][429][430].…”

Section: Infections and Immunological Aetiologies Of Sudden Deathmentioning

confidence: 99%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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In the investigation of sudden death in adults, channelopathies, such as long QT syndrome, have risen to the fore in the minds of forensic pathologists in recent years. Examples of these disorders are touched upon in this review as an absence of abnormal findings at postmortem examination is characteristic and the importance of considering the diagnosis lies in the heritable nature of these conditions. Typically, a diagnosis of a possible channelopathy is evoked as an explanation for a 'negative autopsy' in a case of apparent sudden natural death. However, the one potential adverse effect of this approach is that subtle causes of sudden death may be overlooked. The intention of this article is to review and discuss potential causes of sudden adult death (mostly natural) that should be considered before resorting to a diagnosis of possible channelopathy. Nonetheless, it becomes apparent that many of the potential causes of sudden death can have a genetic basis. Thus, it becomes an important consideration that there may be a genetic basis to sudden death that extends beyond the negative autopsy.

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“…Post-mortem studies suggest that these data may underestimate fatal hymenoptera allergy. Hoffman et al found IgE antibodies to hyrnenoptera venoms in half of 10 sera samples collected from adults who had died suddenly and unexpectedly [9]. In a larger study, Schwartz et al [10] reported that 22 out of 94 sera (32%) obtained from 15-to 65-year-old sudden death victims showed elevated IgE antibodies to at least one insect venom.…”

Section: Hymenoptera Allergy As a Public Health Hazardmentioning

confidence: 99%