Adverse events associated with rush hymenoptera venom immunotherapy

To determine the incidence and nature of adverse events associated with the induction of rush Hymenoptera venom immunotherapy.

Retrospective descriptive case study.

The asthma and allergy unit at a major metropolitan teaching hospital, between 1 January 1989 and 30 June 1999.

All patients with anaphylaxis to stings of Hymenoptera insects who received rush venom immunotherapy as inpatients.

Hypersensitivity reactions to venom administration, including angioedema, skin rashes, hypotension and asthma, as well as any other adverse events related to the inpatient stay.

68 venom-allergic patients received 73 courses of rush immunotherapy; 89% were desensitised to honey bee venom, 10% to yellow jacket wasp venom, and one to paper wasp venom. Hypersensitivity reactions occurred after 36 subcutaneous injections (3.8% of all injections given) in 26 patients (38%).

In our cohort, immunotherapy was accompanied by a high incidence of adverse systemic events during the induction phase. Immunotherapy should only be given by experienced staff in centres where there are facilities for resuscitation.