PMID- 16197464
OWN - NLM
STAT- MEDLINE
DCOM- 20060323
LR  - 20220409
IS  - 0105-4538 (Print)
IS  - 0105-4538 (Linking)
VI  - 60
IP  - 11
DP  - 2005 Nov
TI  - Diagnosis of Hymenoptera venom allergy.
PG  - 1339-49
AB  - The purpose of diagnostic procedure is to classify a sting reaction by history, 
      identify the underlying pathogenetic mechanism, and identify the offending 
      insect. Diagnosis of Hymenoptera venom allergy thus forms the basis for the 
      treatment. In the central and northern Europe vespid (mainly Vespula spp.) and 
      honeybee stings are the most prevalent, whereas in the Mediterranean area stings 
      from Polistes and Vespula are more frequent than honeybee stings; bumblebee 
      stings are rare throughout Europe and more of an occupational hazard. Several 
      major allergens, usually glycoproteins with a molecular weight of 10-50 kDa, have 
      been identified in venoms of bees, vespids. and ants. The sequences and 
      structures of the majority of venom allergens have been determined and several 
      have been expressed in recombinant form. A particular problem in the field of 
      cross-reactivity are specific immunoglobulin E (IgE) antibodies directed against 
      carbohydrate epitopes, which may induce multiple positive test results (skin 
      test, in vitro tests) of still unknown clinical significance. Venom 
      hypersensitivity may be mediated by immunologic mechanisms (IgE-mediated or 
      non-IgE-mediated venom allergy) but also by nonimmunologic mechanisms. Reactions 
      to Hymenoptera stings are classified into normal local reactions, large local 
      reactions, systemic toxic reactions, systemic anaphylactic reactions, and unusual 
      reactions. For most venom-allergic patients an anaphylactic reaction after a 
      sting is very traumatic event, resulting in an altered health-related quality of 
      life. Risk factors influencing the outcome of an anaphylactic reaction include 
      the time interval between stings, the number of stings, the severity of the 
      preceding reaction, age, cardiovascular diseases and drug intake, insect type, 
      elevated serum tryptase, and mastocytosis. Diagnostic tests should be carried out 
      in all patients with a history of a systemic sting reaction to detect 
      sensitization. They are not recommended in subjects with a history of large local 
      reaction or no history of a systemic reaction. Testing comprises skin tests with 
      Hymenoptera venoms and analysis of the serum for Hymenoptera venom-specific IgE. 
      Stepwise skin testing with incremental venom concentrations is recommended. If 
      diagnostic tests are negative they should be repeated several weeks later. Serum 
      tryptase should be analyzed in patients with a history of a severe sting 
      reaction.
FAU - Bilo, B M
AU  - Bilo BM
AD  - Allergy Unit, Department of Internal Medicine, Immunology, Allergy and 
      Respiratory Diseases, Ancona, Italy.
FAU - Rueff, F
AU  - Rueff F
FAU - Mosbech, H
AU  - Mosbech H
FAU - Bonifazi, F
AU  - Bonifazi F
FAU - Oude-Elberink, J N G
AU  - Oude-Elberink JN
CN  - EAACI Interest Group on Insect Venom Hypersensitivity
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 0 (Allergens)
RN  - 0 (Arthropod Venoms)
RN  - 0 (Venoms)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Allergens/*adverse effects/analysis/chemistry/immunology
MH  - Animals
MH  - Antibody Specificity
MH  - Arthropod Venoms/*adverse effects/analysis/chemistry/immunology
MH  - Humans
MH  - Hymenoptera/*immunology
MH  - Hypersensitivity/blood/*diagnosis/epidemiology
MH  - Immunoglobulin E/blood
MH  - Insect Bites and Stings/epidemiology
MH  - Molecular Weight
MH  - Prevalence
MH  - Risk Factors
MH  - Skin Tests
MH  - Venoms
RF  - 144
FIR - Birnbaum, J
IR  - Birnbaum J
FIR - Bucher, C
IR  - Bucher C
FIR - Forster, J
IR  - Forster J
FIR - Hemmer, W
IR  - Hemmer W
FIR - Incorvaia, C
IR  - Incorvaia C
FIR - Kontou-Fili, K
IR  - Kontou-Fili K
FIR - Gawlik, R
IR  - Gawlik R
FIR - Muller, U
IR  - Muller U
FIR - Fernandez, J
IR  - Fernandez J
FIR - Jarish, R
IR  - Jarish R
FIR - Jutel, M
IR  - Jutel M
FIR - Wuthrich, B
IR  - Wuthrich B
EDAT- 2005/10/04 09:00
MHDA- 2006/03/24 09:00
CRDT- 2005/10/04 09:00
PHST- 2005/10/04 09:00 [pubmed]
PHST- 2006/03/24 09:00 [medline]
PHST- 2005/10/04 09:00 [entrez]
AID - ALL963 [pii]
AID - 10.1111/j.1398-9995.2005.00963.x [doi]
PST - ppublish
SO  - Allergy. 2005 Nov;60(11):1339-49. doi: 10.1111/j.1398-9995.2005.00963.x.