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Venom allergy testing: is a graded approach necessary?
Jaclyn A Quirt1, Xia Wen2, Jonathan Kim3
1Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Summary
A single-step approach to venom allergy testing is safe and effective. This method reduces patient discomfort and healthcare costs compared to traditional stepwise testing protocols.
Area of Science:
- Allergy and Immunology
- Clinical Medicine
Background:
- Stepwise intradermal testing for venom allergy is standard but costly and uncomfortable.
- The rationale for stepwise testing is to minimize adverse reactions to high doses.
Purpose of the Study:
- To assess the safety of a single-step protocol for venom allergy testing.
Main Methods:
- Retrospective chart review of 300 patients with suspected hymenoptera venom allergy.
- All patients received a single-step intradermal skin test using a standardized venom concentration.
- Adverse reactions (immediate and delayed) were recorded.
Main Results:
- Only one patient (0.33%) reported a delayed adverse reaction.
- No immediate adverse reactions were observed during testing.
- The patient with a delayed reaction proceeded to successful venom immunotherapy.
Conclusions:
- A single-step venom allergy intradermal testing protocol using a 1.0-μg/mL concentration is safe.
- Adoption of this protocol can streamline patient care and reduce healthcare costs.
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