Insect sting allergy in adults: key messages for clinicians.

Insect sting allergy in adults: key messages for clinicians. Pol Arch Med Wewn. 2015 Sep 3; Authors: Nittner-Marszalska M, Cichocka-Jarosz E Abstract During their lifetimes, 94.5% of all people are stung by wasps, honey-bees, hornets or bumble-bees (order Hymenoptera). After a sting, most of them have typical local symptoms, 5-15% of the stung individuals develop local allergic reactions and 3-8.9% manifest systemic allergic reactions (SR) which may be potentially life-threatening in 10% of them. In the mild forms of Hymenoptera venom allergy (HVA), grades I and II according to Mueller, the leading symptoms are urticaria and edema, respectively. Severe SR are classified as grades III (respiratory symptoms) and IV (cardiovascular symptoms). Rare manifestations of HVA are Kounis syndrome and Tako-tsubo cardiomyopathy. All HVA patients with SR require standard (skin test, sIgE, tryptase) or extended (component diagnosis, basophil activation test) HVA diagnosis. All the patients with SR manifesting hypertension and disturbances in consciousness should be diagnosed for mastocytosis. Additionally, a relationship was found between the severity of HVA symptoms and intake of ACEI. A similar, though less documented, reservation concerns the use of beta blockers. HVA patients who have experienced SR are potential candidates for venom immunotherapy (VIT) which is effective in 80-100% of the individuals treated for 3-5 years. A heightened risk of...
Source: Polskie Archiwum Medycyny Wewnetrznej - Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research