title: Efficacy and safety of rush immunotherapy in patients with Hymenoptera allergy in Japan.
abstract: In Japan, approximately 40 persons die annually from anaphylaxis caused by Hymenoptera stings. Venom immunotherapy is considered safe and effective for the treatment of allergic systemic reactions caused by Hymenoptera stings in patients with Hymenoptera allergy. We studied the efficacy and safety of rush immunotherapy in patients who had a history of systemic reactions to Hymenoptera stings in Japan. Between 1988 and 2002, 95 patients with a history of systemic reactions to Hymenoptera stings were investigated. The stings originated from honeybees in 5 patients, yellow jackets in 28, wasps in 48, both yellow jackets and wasps in 9, and both yellow jackets and honeybees in 5. All patients had venom-specific IgE antibodies in sera (RAST score > or = 2) and received rush immunotherapy with venom extracts at our hospital. Forty-three patients had 63 field re-stings during immunotherapy. Of these patients, 41 (95.3%) with 59 field re-stings (93.7%) had no systemic reactions. Two patients (4.7%) with four field restings (6.3%) had anaphylactic shock. Although anaphylactic reactions developed in two patients (2.1%) during rush immunotherapy with honeybee venom and one patient (1.1%) during maintenance therapy wasp venom, systemic adverse reactions were mitigated by treatment with antihistamines before venom injection. Our results show that immunotherapy is safe and effective for the prevention of systemic reactions to Hymenoptera re-stings in patients with Hymenoptera allergy. We therefore recommend that patients who are allergic to Hymenoptera venom prophylactically receive immunotherapy.
authors: Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University School of Medicine, Tochigi, Japan.
authors: Hirokuni
authors: H
authors: Hirata
authors: Takuma
authors: T
authors: Asakura
authors: Masafumi
authors: M
authors: Arima
authors: Gang
authors: G
authors: Cheng
authors: Kyoko
authors: K
authors: Honda
authors: Fumiya
authors: F
authors: Fukushima
authors: Bunpei
authors: B
authors: Yamaguchi
authors: Nozomi
authors: N
authors: Yoshida
authors: Takeshi
authors: T
authors: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000209:etiology / Q000628:therapy; D000818:Animals; D001180:Arthropod Venoms / Q000008:administration & dosage / Q000009:adverse effects; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006801:Humans; D006927:Hymenoptera; D006967:Hypersensitivity / Q000209:etiology* / Q000628:therapy*; D007167:Immunotherapy; D007299:Insect Bites and Stings / Q000150:complications* / Q000628:therapy*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014581:Urticaria / Q000209:etiology / Q000628:therapy
chemical_list: D001180:Arthropod Venoms