Adverse events associated with rush hymenoptera venom immunotherapy.
OBJECTIVE
To determine the incidence and nature of adverse events associated with the induction of rush Hymenoptera venom immunotherapy.


METHODS
Retrospective descriptive case study.


METHODS
The asthma and allergy unit at a major metropolitan teaching hospital, between 1 January 1989 and 30 June 1999.


METHODS
All patients with anaphylaxis to stings of Hymenoptera insects who received rush venom immunotherapy as inpatients.


METHODS
Hypersensitivity reactions to venom administration, including angioedema, skin rashes, hypotension and asthma, as well as any other adverse events related to the inpatient stay.


RESULTS
68 venom-allergic patients received 73 courses of rush immunotherapy; 89% were desensitised to honey bee venom, 10% to yellow jacket wasp venom, and one to paper wasp venom. Hypersensitivity reactions occurred after 36 subcutaneous injections (3.8% of all injections given) in 26 patients (38%).


CONCLUSIONS
In our cohort, immunotherapy was accompanied by a high incidence of adverse systemic events during the induction phase. Immunotherapy should only be given by experienced staff in centres where there are facilities for resuscitation.
Westall
G P
GP
Department of Allergy, Asthma and Clinical Immunology, The Alfred and Monash University, Melbourne, VIC.
Thien
F C
FC
Czarny
D
D
O'Hehir
R E
RE
Douglas
J A
JA
D000328:Adult; D000707:Anaphylaxis / Q000276:immunology / Q000628:therapy; D000818:Animals; D001514:Bee Venoms / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology; D003888:Desensitization, Immunologic / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000276:immunology; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D007279:Injections, Subcutaneous; D008297:Male; D012189:Retrospective Studies
D001514:Bee Venoms; D007073:Immunoglobulin E