Approach to Patients with Stinging Insect Allergy

被引:7
作者
Abrams, Elissa M. [1 ]
Golden, David B. K. [2 ]
机构
[1] Univ Manitoba, Sect Allergy & Clin Immunol, Dept Pediat, FE125-685 William Ave, Winnipeg, MB R2A 5L9, Canada
[2] Johns Hopkins Univ, Sch Med, Dept Med, 20 Crossrd Dr,Suite 16, Owings Mills, MD 21117 USA
关键词
Stinging insect; Anaphylaxis; Venom immunotherapy; Large local reaction; HYMENOPTERA VENOM ALLERGY; LARGE LOCAL REACTIONS; FIRE ANT IMMUNOTHERAPY; YELLOW JACKET VENOM; NATURAL-HISTORY; ANAPHYLACTIC REACTIONS; SERUM TRYPTASE; BIPHASIC ANAPHYLAXIS; CLINICAL PREDICTORS; HONEYBEE VENOM;
D O I
10.1016/j.mcna.2019.08.006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Stinging insect allergy is uncommon but can be life threatening. Diagnosis requires clinical history and confirmative skin or blood testing by an allergist. Baseline serum tryptase level can be used to stratify risk. Treatment is supportive for all reactions except for anaphylaxis, which is treated with intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids, and oxygen. Venom immunotherapy is most effective for long-term management in patients with a history of anaphylaxis. Venom immunotherapy rapidly reduces the risk of sting anaphylaxis by up to 98% and maintenance treatment can be stopped after 5 years in most cases.
引用
收藏
页码:129 / +
页数:16
相关论文
共 98 条
[1]   Acute ITP Due to Insect Bite: Report of 2 Cases [J].
Akbayram, Sinan ;
Akgun, Cihangir ;
Dogan, Murat ;
Caksen, Huseyin ;
Oner, Ahmet Faik .
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS, 2011, 17 (04) :408-409
[2]  
Akdur O, 2013, CASE REP EMERG MED, V2013
[3]   Do Corticosteroids Prevent Biphasic Anaphylaxis? [J].
Alqurashi, Waleed ;
Ellis, Anne K. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2017, 5 (05) :1194-1206
[4]   Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis [J].
Alqurashi, Waleed ;
Stiell, Ian ;
Chan, Kevin ;
Neto, Gina ;
Alsadoon, Abdulaziz ;
Wells, George .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2015, 115 (03) :217-+
[5]   A 1-day imported fire ant rush immunotherapy schedule with and without premedication [J].
Arseneau, April M. ;
Nesselroad, Teresa D. ;
Dietrich, Jeffrey J. ;
Moore, Laura M. ;
Nguyen, Steven ;
Hagan, Larry L. ;
Tankersley, Michael S. .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2013, 111 (06) :562-566
[6]   Epidemiology of insect-venom anaphylaxis [J].
Bilo, Beatrice M. ;
Bonifazi, Floriano .
CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY, 2008, 8 (04) :330-337
[7]   RAPID HYMENOPTERA VENOM IMMUNOTHERAPY - COMPARATIVE SAFETY OF 3 PROTOCOLS [J].
BIRNBAUM, J ;
CHARPIN, D ;
VERVLOET, D .
CLINICAL AND EXPERIMENTAL ALLERGY, 1993, 23 (03) :226-230
[8]   Further fatalities caused by anaphylactic reactions to food, 2001-2006 [J].
Bock, S. Allan ;
Munoz-Furlong, Anne ;
Sampson, Hugh A. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2007, 119 (04) :1016-1018
[9]   Mastocytosis and insect venom allergy [J].
Bonadonna, Patrizia ;
Zanotti, Roberta ;
Mueller, Ulrich .
CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY, 2010, 10 (04) :347-353
[10]   Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels [J].
Bonadonna, Patrizia ;
Perbellini, Omar ;
Passalacqua, Giovanni ;
Caruso, Beatrice ;
Colarossi, Sabrina ;
Dal Fior, Daniela ;
Castellani, Luca ;
Bonetto, Chiara ;
Frattini, Francesco ;
Dama, Annarita ;
Martinelli, Giovanni ;
Chilosi, Marco ;
Senna, Gianenrico ;
Pizzolo, Giovanni ;
Zanotti, Roberta .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2009, 123 (03) :680-686