How much specific is the association between hymenoptera venom allergy and mastocytosis?

Bonadonna, Patrizia; Zanotti, Roberta; Pagani, Mauro; Caruso, Beatrice; Perbellini, Omar; Colarossi, Sabrina; Olivieri, Elisa; Dama, Annarita; Schiappoli, Michele; Senna, Gianenrico; Antico, Andrea; Passalacqua, Giovanni

doi:10.1111/j.1398-9995.2009.02108.x

Cited by 80 publications

(59 citation statements)

References 18 publications

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“…The incidence of clonal mast cell disease in patients who experienced anaphylaxis resulting from other triggers, such as drugs and food, was also investigated in a series of 137 patients with food and drug allergies [34]. Nine patients in this group (6.6%) had elevated tryptase levels, and only two (1.5%) were diagnosed with systemic mastocytosis.…”

Section: Major Criterion Multifocal Clusters Of ≥ 15 Mast Cells In a mentioning

confidence: 99%

Anaphylaxis and Mast Cell Disease: What Is the Risk?

Akin

2010

Curr Allergy Asthma Rep

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Mastocytosis is a proliferative disorder of the hematopoietic mast cell progenitor that results from expansion of a clone carrying the D816V c-kit mutation. Based on the dramatic increase in incidence of anaphylaxis in patients with mastocytosis, recent studies analyzed the presence of clonal mast cell markers, including D816V c-kit mutation, in patients with recurrent IgE- and non-IgE-mediated anaphylaxis. These studies demonstrated the presence of an aberrant mast cell clone in a significant proportion of patients with unexplained anaphylaxis, or anaphylaxis due to hymenoptera venom. Clonal mast cell disease should be suspected in particular in patients presenting with profound cardiovascular manifestations such as hypotension and syncope in the absence of urticaria.

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Section: Major Criterion Multifocal Clusters Of ≥ 15 Mast Cells In a mentioning

confidence: 99%

Anaphylaxis and Mast Cell Disease: What Is the Risk?

Akin

2010

Curr Allergy Asthma Rep

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“…These data, among others, illustrate the strong association between HVA and mastocytosis. 62 Measurement of baseline serum tryptase level may be a useful screening test for mastocytosis in patients with systemic reactions after Hymenoptera stings. However, a significant but variable proportion of patients will have levels ,20 ng/mL, which creates a dilemma in terms of the cutoff level for BM biopsy.…”

Section: -58mentioning

confidence: 99%

How I treat patients with indolent and smoldering mastocytosis (rare conditions but difficult to manage)

Pardanani

2013

Blood

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Indolent systemic mastocytosis (SM) patients have a varied clinical presentation, ranging from predominantly cutaneous symptoms to recurrent systemic symptoms (eg, flushing, palpitations, dyspepsia, diarrhea, bone pain) that can be severe and potentially life threatening (anaphylaxis). Mastocytosis patients without skin involvement pose a diagnostic challenge; a high index of suspicion is needed in those with mast cell–degranulation symptoms, including anaphylaxis following Hymenoptera stings or other triggers. Modern-era molecular and flow-cytometric diagnostic methods are very sensitive and can detect minimal involvement of bone marrow with atypical/clonal mast cells; in some cases, full diagnostic criteria for SM are not fulfilled. An important aspect of treatment is avoidance of known symptom triggers; other treatment principles include a stepwise escalation of antimediator therapies and consideration of cytoreductive therapies for those with treatment-refractory symptoms. The perioperative management of mastocytosis patients is nontrivial; a multidisciplinary preoperative assessment, adequate premedications, and close intra- and postoperative monitoring are critical. Smoldering mastocytosis is a variant with high systemic mast cell burden. While its clinical course can be variable, there is greater potential need for cytoreductive therapies (eg, interferon-alpha, cladribine) in this setting. A systematic approach to the diagnosis and treatment of indolent SM using a case-based approach of representative clinical scenarios is presented here.

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“…Hymenoptera stings are the main triggers of anaphylaxis (excluding idiopathic cases) in patients with indolent systemic mastocytosis (ISM) [99,100], with a prevalence of 5%-19% [99,101]. These figures increase in specific forms of the disorder, such as ISM without skin lesions.…”

Section: Management Of Indolent Systemic Mastocytosis and Anaphylaxismentioning

confidence: 98%

Key Issues in Hymenoptera Venom Allergy: An Update

Alfaya

Soriano-Gomis

Mera

et al. 2017

J Investig Allergol Clin Immunol

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In this review, the Hymenoptera Allergy Committee of the SEAIC analyzes the most recent scientific literature addressing problems related to the diagnosis of hymenoptera allergy and to management of venom immunotherapy. Molecular diagnosis and molecular risk profiles are the key areas addressed. The appearance of new species of hymenoptera that are potentially allergenic in Spain and the associated diagnostic and therapeutic problems are also described. Finally, we analyze the issue of mast cell activation syndrome closely related to hymenoptera allergy, which has become a new diagnostic challenge for allergists given its high prevalence in patients with venom anaphylaxis.

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How much specific is the association between hymenoptera venom allergy and mastocytosis?

Abstract: The association of clonal mast cell disorders with hymenoptera allergy seems to be more specific than that with food- or drug-induced systemic reactions.

Cited by 80 publications

References 18 publications

Anaphylaxis and Mast Cell Disease: What Is the Risk?

Anaphylaxis and Mast Cell Disease: What Is the Risk?

How I treat patients with indolent and smoldering mastocytosis (rare conditions but difficult to manage)

Key Issues in Hymenoptera Venom Allergy: An Update

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