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An Introduction to Parasitic Wasps of Drosophila and the Antiparasite Immune Response
Published on: May 7, 2012
The wasp-horsefly syndrome.
O Quercia1, F Emiliani, F G Foschi
1Dipartimento di Medicina Interna, Ospedale per gli Infermi di Faenza (RA), Italia.
European Annals of Allergy and Clinical Immunology
|August 23, 2008
Summary
Two patients with stinging hymenoptera venom allergy experienced severe reactions after horsefly bites. This suggests a potential "wasp-horsefly syndrome" due to cross-reactivity, increasing anaphylaxis risk.
Area of Science:
- Allergology and Immunology
- Entomology
- Clinical Medicine
Background:
- Individuals with known allergies to stinging hymenoptera venom are susceptible to other insect-related allergic reactions.
- Hyaluronidase is a known cross-allergen implicated in the wasp-mosquito syndrome.
- Horsefly (Tabanidae) bites can occur in environments frequented by animals and near water sources.
Observation:
- Two male patients (57 and 62 years old) with pre-existing hymenoptera venom allergy developed severe (Mueller grade 3-4) systemic reactions following horsefly bites.
- Diagnostic procedures included clinical assessment, environmental history, skin prick tests, and RAST (Radioallergosorbent test).
- Entomological confirmation was also performed.
Findings:
- The observed severe reactions suggest a potential cross-reactivity between hymenoptera venom and horsefly saliva, similar to the described wasp-mosquito syndrome.
- A novel 'wasp-horsefly syndrome' is proposed, highlighting an increased risk of anaphylaxis in hymenoptera-sensitized individuals upon Tabanidae exposure.
- Systemic reactions in these patients may be attributed to Tabanidae bites rather than immunotherapy failure for hymenoptera venom.
Implications:
- This finding necessitates considering Tabanidae bites as a significant trigger for anaphylaxis in sensitized individuals.
- Clinicians should investigate horsefly bites in patients with hymenoptera venom allergy presenting with severe systemic reactions.
- Further research into cross-allergenicity between hymenoptera venom and Tabanidae saliva is warranted to understand and manage these reactions effectively.
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