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Hymenoptera Anaphylaxis and C-kit Mutations: An Unexpected Association
Patrizia Bonadonna1, Massimiliano Bonifacio, Carla Lombardo
1Allergy Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy, patrizia.bonadonna@ospedaleuniverona.it.
Current Allergy and Asthma Reports
|July 8, 2015
Summary
Mastocytosis patients often experience severe allergic reactions to insect stings, even with normal tryptase levels. Recognizing this link is crucial for diagnosing mast cell disorders and managing Hymenoptera venom allergy (HVA).
Area of Science:
- Immunology
- Allergy
- Hematology
Background:
- Mastocytosis involves mast cell (MC) activation, leading to symptoms like anaphylaxis.
- Systemic mastocytosis is diagnosed via WHO criteria, while other clonal MC disorders show specific genetic markers.
- A significant association exists between mastocytosis and Hymenoptera venom allergy (HVA).
Purpose of the Study:
- To highlight the strong link between mastocytosis and Hymenoptera venom allergy (HVA).
- To describe the typical presentation of HVA in mastocytosis patients.
- To emphasize the importance of considering MC disorders in severe HVA cases.
Main Methods:
- Review of clinical manifestations in adult mastocytosis.
- Analysis of HVA prevalence in mastocytosis cohorts.
- Characterization of HVA presentation in patients with underlying MC disorders.
Main Results:
- HVA affects 20-50% of mastocytosis patients, rising to 60-80% in indolent forms without skin lesions.
- Severe hypotension during HVA, without typical skin symptoms, is characteristic of underlying MC disorders.
- Normal baseline serum tryptase levels do not exclude an underlying MC disorder in HVA patients.
Conclusions:
- Mastocytosis patients have a high risk of severe Hymenoptera venom allergy (HVA).
- The presentation of HVA with severe hypotension, irrespective of skin symptoms or tryptase levels, suggests an underlying mast cell disorder.
- Early diagnosis and management of MC disorders are vital for patients with severe HVA.
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