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Coexistent anaphylaxis to Diptera and Hymenoptera

H B Freye, C Litwin

    Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
    |March 1, 1996
    PubMed
    Summary

    Anaphylaxis to horsefly bites is rare but can occur alongside Hymenoptera allergies. Current skin and RAST tests using whole body extracts are ineffective for diagnosing Tabanidae hypersensitivity.

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    Area of Science:

    • Allergy and Immunology
    • Insect Allergy
    • Diptera and Hymenoptera Hypersensitivity

    Background:

    • Anaphylaxis to Diptera, particularly Tabanidae (horseflies), is infrequently reported.
    • Coexistent hypersensitivity to both Diptera and Hymenoptera orders has not been previously documented.

    Observation:

    • A case study of a 56-year-old male presenting with anaphylaxis to both horsefly bites and Hymenoptera venom.
    • Diagnostic evaluations included venom skin testing and RAST for Hymenoptera, and prick, intradermal, and RAST tests with whole body extracts of Tabanidae species.

    Findings:

    • The patient exhibited anaphylactic reactions to both Hymenoptera envenomation and horsefly bites.
    • Control groups of 20 Hymenoptera-sensitive patients showed no reaction to horsefly bites, despite positive skin tests or RAST to Tabanidae extracts.
    • Whole body extracts for skin testing and RAST are not useful for diagnosing Tabanidae hypersensitivity.

    Implications:

    • Current diagnostic methods using whole body extracts are inadequate for identifying horsefly hypersensitivity.
    • Accurate diagnosis of horsefly allergy may be possible with the future availability of salivary gland antigens.
    • This study highlights the potential for dual allergies to Diptera and Hymenoptera, necessitating further research into diagnostic markers.

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