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Basophil Activation Test for Allergy Diagnosis
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Risk factors in Hymenoptera venom allergy.

F Ruëff1, J Kroth1, B Przybilla1

  • 1AllergieZentrum, Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Munich, Germany.

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|November 8, 2018
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Summary
This summary is machine-generated.

Identifying risk factors is crucial for offering venom immunotherapy (VIT) and managing treatment. Key factors influence severe reactions and treatment failure in Hymenoptera sting allergies.

Keywords:
honey bee venommastocytosisrisk factorspecific immunotherapytryptasewasp venom

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Area of Science:

  • Allergy and Immunology
  • Toxicology

Background:

  • Systemic anaphylactic reactions (SAR) following Hymenoptera stings pose significant health risks.
  • Venom immunotherapy (VIT) is an effective treatment, but requires careful patient selection and management due to potential risks.

Purpose of the Study:

  • To identify risk factors associated with severe systemic anaphylactic reactions (SAR) after Hymenoptera stings.
  • To determine risk factors for SAR during VIT and treatment failure.
  • To provide guidance on optimizing VIT protocols based on identified risks.

Main Methods:

  • Review of clinical data and literature on Hymenoptera sting reactions and VIT.
  • Analysis of patient characteristics, sting history, and treatment parameters.
  • Identification of correlations between risk factors and outcomes (SAR, treatment failure).

Main Results:

  • Risk factors for SAR include prior sting severity, wasp stings, elevated baseline serum tryptase concentration (BSTC), mastocytosis, older age, ACE inhibitor use, and male gender.
  • During VIT, honey bee venom treatment, high BSTC (for vespid VIT), venom-specific IgE, antihypertensive medication, and ultra-rush protocols increase SAR risk.
  • Treatment failure is linked to honey bee venom allergy, high BSTC (for vespid VIT), mastocytosis, and prior VIT side effects.

Conclusions:

  • Risk factor assessment is essential for personalized VIT decisions and administration.
  • Minimizing risks involves managing antihypertensive medications and adjusting build-up protocols.
  • Increasing maintenance doses may enhance VIT efficacy, especially in high-risk patients or those with treatment failure, with 200 µg often being sufficient.