Hymenoptera venom immunotherapy – when and whom to qualify for treatment Review article
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Abstract
Hymenoptera venom allergy is the most common cause of anaphylactic shock in adults. In children it is second cause, just after food allergy. In Poland, the most common causes of allergies are stings by honeybees (Apis mellifera), wasps (Vespula spp.) and hornets (Vespa spp.).
Usually sting cause a local reaction, however, in approximately 3% of adults and 0.5% of children the reaction is systemic anaphylaxis. The diagnosis of venom hypersensitivity can be difficult, especially when the medical interview does not clearly indicate the causative insect. The diagnosis bases on skin tests with wasp and bee venom: prick test and intradermal (with a total sensitivity of 94%), and determination of the level of specific IgE (the sensitivity of the test ranges from 83% to 100%). The mainstay of treatment is specific immunotherapy, for which patients with severe anaphylactic reactions and a proven IgE-dependent mechanism of allergy are qualified. In exceptional situations, patients with severe local reactions, exposed to frequent stings due to their work and with isolated skin lesions, which significantly reduce their quality of life are qualified for the treatment. Specific immunotherapy is the only effective treatment method, it lasts 3–5 years, and its effectiveness is 91–96% in wasp venom allergy and 77–84% in bee venom allergy.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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