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Published on: June 4, 2017
Insect allergy in children
1Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. dgolden1@jhmi.edu
Insights
Children with insect sting allergies experience unique patterns compared to adults. Venom immunotherapy offers long-lasting protection for moderate to severe reactions, with children showing greater immune tolerance.
Area of Science:
- Pediatric Allergy and Immunology
- Insect Venom Allergy
- Immunotherapy
Background:
- Insect sting allergy presents distinct characteristics in pediatric populations.
- Understanding these differences is crucial for accurate diagnosis and management.
Purpose of the Study:
- To review and update existing literature on insect sting allergy specifically in children.
- To highlight unique aspects of pediatric insect allergy compared to adults.
Main Methods:
- Systematic review of published data on pediatric insect sting allergy.
- Analysis of reaction patterns, severity, recurrence, and treatment outcomes.
Main Results:
- Honeybee allergy is more prevalent in children.
- Severe reactions are less common, but mild cutaneous reactions occur in over 60% of children.
- Children with moderate to severe reactions face long-term risks, but exhibit greater immune tolerance with venom immunotherapy.
Conclusions:
- Children with mild systemic reactions to stings do not typically require testing or immunotherapy.
- Venom immunotherapy is recommended for children with moderate to severe reactions, providing decades of protection.
- Pediatric patients demonstrate superior long-term immune tolerance following immunotherapy compared to adults.
Purpose Of Review:
Some aspects of insect sting allergy are unique in children. This review will identify and update the published data that exist pertaining specifically to insect allergy in children.
Recent Findings:
Children have a different pattern of insect sting allergy than adults. Honeybee allergy is more common in children. Severe systemic reactions are less common than in adults but the risk of recurrence can persist for decades. Systemic reactions are limited to mild 'cutaneous' reactions in over 60% of children (but only 15% of adults). Children with mild systemic reactions rarely get worse. Children with moderate or severe systemic reactions still had a 30% chance of a similar reaction even 20 years later. The long-term immune tolerance induced by venom immunotherapy is greater in children than adults. Children who had received venom immunotherapy for 3-5 years were still immune 10-20 years later.
Summary:
Children with insect sting allergy are tested and treated in much the same way as adults. Children with mild systemic reactions do not require testing or immunotherapy. Children with moderate to severe systemic reactions are at risk for decades and should receive venom immunotherapy, which gives very long-lasting protection.
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