Favorable hymenoptera sting reactions during childhood may have enabled transmission of responsible allergic genotype into generations

Mingomataj, Ervin

doi:10.1016/j.mehy.2006.01.052

Medical Hypotheses

2006

DOI: 10.1016/j.mehy.2006.01.052

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Favorable hymenoptera sting reactions during childhood may have enabled transmission of responsible allergic genotype into generations

Ervin Mingomataj

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Cited by 2 publications

References 43 publications

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Unusual Reactions to Hymenoptera Stings: What Should we Keep in Mind?

Mingomataj

Bakiri

Ibranji

et al. 2014

Clinic Rev Allerg Immunol

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This review includes a variety of extremely rare and unusual hymenoptera sting (HS) circumstances with regard to sting localization, geographic region, massivity of multiple stings, and particularly related to clinical symptoms. Such reactions occur in a temporal relationship to HS (s), differ from typical allergic symptomatology, and sometimes need follow-up during many months. With respect to pathogenesis, the major mechanisms involved are toxic, autoimmune, and other delayed immunological ones. While delayed inflammatory symptoms of the nervous system are considered as delayed hypersensitization or autoimmune entities, generalized rhabdomyolysis and consecutive acute kidney injury is considered a toxic reaction, mostly induced by massive envenomation to wasps or "Africanized" bees. Hemorrhagic episodes of targeted organ (s) could be additional potential risk for acute kidney injury, while the bee venom-induced hemorrhage is proposed to be a nonimmune-mediated anaphylactic symptom. The hemodynamic involvement of vital organs and systems with hypoxia and hypovolemia together with simultaneous immunoglobulin E (IgE) sensitization are considered potential indications for venom immunotherapy. In contrast, patients who have experienced various complications with unknown or nonallergic mechanisms should be informed about the importance of epinephrine's use and additional measures on future sting avoidance. In conclusion, although unusual reactions are extremely rare, it is important to keep them in mind.

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Unusual Reactions to Hymenoptera Stings: What Should we Keep in Mind?

Mingomataj

Bakiri

Ibranji

et al. 2014

Clinic Rev Allerg Immunol

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Approaches to the Management of Presumed Immediate Hymenoptera Venom Allergy and Non-Detectable IgE

Mingomataj¹,

Bakiri²

2010

TOALLJ

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Objective: To provide a comprehensive evaluation in patients with a convincing history of immediate insect allergy but negative skin test and/or specific IgE results, adequately addressing the question of how best to manage them. Data sources: Observational peer-reviewed studies and case reports were searched on Pub-Med database from 1998 up to March 2009 using the following keywords: Hymenoptera Allergy & Negative IgE (Negative Skin Tests). Study selection: Studies on supplemental diagnostic tests that provided data from patients with immediate hymenoptera allergy but negative conventional tests results to the offending allergens were selected. In this work, we also included studies providing additional relevant information regarding this issue. Results: Among 43 identified papers only 9 of them presented relevant original data, while the other papers were reviews. In the majority of the cases, the culprit insect was identified with in vitro tests such as Basophil Activation Test, Cellular Allergen Stimulation Test or Western blot, whereas in vivo (less frequently) with sting challenge or dialyzed venom skin test. Conclusions: The management of patients with a convincing history of immediate insect allergy but negative conventional test results requires an adaption of the guidelines including an incorporation of the novel diagnostic tools. Although cellular tests represent equivalent sensitivity and superior specificity as compared with standard ones, these tests still remain supplementary diagnostic tools. In a minority of cases (especially in the developing countries where cellular tests cannot be performed), venom immunotherapy in adult subjects could be taken into account based solemnly on the history of a clear patient’s identification of the culprit insect.

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Favorable hymenoptera sting reactions during childhood may have enabled transmission of responsible allergic genotype into generations

Cited by 2 publications

References 43 publications

Unusual Reactions to Hymenoptera Stings: What Should we Keep in Mind?

Unusual Reactions to Hymenoptera Stings: What Should we Keep in Mind?

Approaches to the Management of Presumed Immediate Hymenoptera Venom Allergy and Non-Detectable IgE

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