Specific immunotherapy in Albanian patients with anaphylaxis to hymenoptera venoms.
BACKGROUND
Severe allergic reactions during rush-specific immunotherapy (Rush-SIT) may occur in the treatment of hymenoptera sting allergy. The objective of the present study was to examine the characteristics of allergic reactions during Rush-SIT in a cohort of patients with allergy towards hymenoptera venom in the mediterranean population of Albania.


METHODS
A retrospective study was performed using the clinical reports of 37 patients with venom of bee (apinae), wasp (vespidae, subfamily vespinae) or paperwasp (vespidae, subfamily polistinae) allergy treated with Rush-SIT between 1987 and 1996. After hymenoptera sting allergy diagnosis according to anamnesis and intracutaneous tests the patient were treated with Rush-SIT. The protocol lasted 3 - 4 d with an increase in the concentration from 0.01 microg/ml to 100 microg/ml. Anaphylactic reactions were classified according to the Mueller-classification.


RESULTS
The frequency of reactions during Rush-SIT for bee-venom was 4.7% and for wasp-venom was 1.5% (p < 0.01). The mean frequency of reactions of Mueller grade II for the bee-venom Rush-SIT patients during the first 4 d (= 26 injections) was 0.73 and for the wasp-venom Rush-SIT patients 0.15. No patient experienced a third-degree reaction. 94.6% of the patient supported an end dose of 100 microg.


CONCLUSIONS
Rush-SIT is a reliable method for the treatment of anaphylactic reactions to hymenoptera venom even in less developed countries. Bee-venom Rush-SIT was found to cause higher numbers allergic reactions than wasp or paperwasp Rush-SIT.
Dept. of Allergy, Mother Theresa School of Medicine, University of Tirana, Tirana, Albania. allergology@gmx.de
Ervin
E
Mingomataj
Alfred
A
Priftanji
Etleva
E
Qirko
Q Thai
QT
Dinh
Axel
A
Fischer
Christian
C
Peiser
David A
DA
Groneberg
D000328:Adult; D000415:Albania; D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control*; D001514:Bee Venoms / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007279:Injections, Subcutaneous; D007299:Insect Bites and Stings / Q000150:complications*; D008297:Male; D012189:Retrospective Studies; D014862:Wasp Venoms / Q000008:administration & dosage*
D001514:Bee Venoms; D014862:Wasp Venoms