IMMUNOTHERAPY IN INSECT STING ALLERGY - CASE-REPORTS OF THE COURSE OF IMMUNOLOGICAL AND CLINICAL-RESULTS OVER 6 YEARS

Several representative case report were selected from a prospective study on immunotherapy with an aluminum hydroxide adsorbed insect venom extract (Alutard SQ, ALK) in 35 insect sting allergic patients. Clinical data (re-stings), antibody measurements (specific IgE-, IgG-, IgG4-antibodies) and skin test results are shown over a 6 year period. In 35 restings by the relevant insect only one patient with a prior anaphylactic reaction to a bee sting reacted with an angio-edema. The antibody response patterns observed showed a large group of patients with a decrease of specific IgE and a very strong increase of specific IgG and IgG4. Some patients showed a rather minimal decrease in IgE but there were in all patients marked increases of specific IgG and IgG4. In a few patients an increase of specific IgE at the begin of immunotherapy was observed, followed by a decrease in the following months. Also the skin test reactivity decreased over three years, but only in a few patients the intracutaneous tests turned to be negative.