Venom immunotherapy in hymenoptera sting allergy. Comparison of rush and conventional hyposensitization and observations during long-term treatment.
42 patients with confirmed hypersensitivity to honey bee (HBV) and/or yellow jacket (YJV) were treated with the respective venoms (7 with HBV, 5 with VJV and 30 with both venoms). Treatment tolerance, skin tests (ST), specific IgE- and specific IgG-antibodies were monitored before, after 3, 6, 12, 24 and 36 months. 21 patients had a rush and 21 a conventional treatment schedule. Maintenance dose was 100 micrograms. Adverse effects occurred as large local (8 patients), slight systemic (12 patients) and moderate to severe systemic reactions (4 patients). Of 24 re-exposed patients 17 had no reaction at all, six a markedly decreased and one an unchanged reaction. After 3 years of treatment ST became negative in nine of 31 patients on HBV and in seven of 26 patients on YJV. RAST became negative in three of 30 patients on HBV and 17 of 29 patients on YJV treatment. Both ST and RAST became negative in five HBV- and 10 YJV-treated patients. Loss of venom hypersensitivity according to diagnostic tests may correspond to actual desensitization and enable discontinuation of immunotherapy.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001514:Bee Venoms / Q000009:adverse effects / Q000276:immunology*; D002648:Child; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D006967:Hypersensitivity / Q000175:diagnosis / Q000628:therapy*; D007073:Immunoglobulin E / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007299:Insect Bites and Stings / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011852:Radioallergosorbent Test; D012882:Skin Tests
D001514:Bee Venoms; D007074:Immunoglobulin G; D007073:Immunoglobulin E