[Diagnosis and venom specific immunotherapy (VIT) in allergic children in Poland--how much the current practice follows the international guidelines?].
BACKGROUND
Insect venom allergy requires a high level approach adequate to allergy intensity. In case of severe IgE-mediated sting reactions, in children older than five years, venom immunotherapy is a treatment of choice.


OBJECTIVE
Identification of current practices applied to venom allergic children in Poland and their adherence to the international guidelines.


METHODS
Questionnaire survey concerning diagnostic and treatment rules was carried out in 8 centres of pediatric allergology, based on a similar audit conducted in the United Kingdom [Diwakar L. et al. Clin Exp Allergy 2008, 38: 1651].


RESULTS
In 5 centres both RAST and SPT tests were used as the first line of investigation. Subsequently 6 centres performed IDT. In three centres baseline serum tryptase levels were estimated. In case of sensitization to both bee and wasp venom in a child with the history of severe systemic reaction, but uncertain culprit insect, specific venom immunotherapy with both venoms was practised by 2 centres. In systemic reaction and not-detectable IgE in 6 centres child was followed-up in 6-12 months. Antihistamine premedication concerned all children in 7 centres. Six-week interval between booster doses was applied in half of centres. A target dose equal 100 mcg was used in 7 centres. Similarly all centres practiced 3-5 five year period of VIT.


CONCLUSIONS
In Poland current practice with venom allergic children was conducted in congruence with most of the recommendations.
Cichocka-Jarosz
Ewa
E
Oddzial Pulmonologii i Alergologii Kliniki Chorób Dzieci Katedry Pediatrii UJ CM Kierownik Katedry i Kliniki. mijarosz@cyf-kr.edu.pl
Brzyski
Piotr
P
Lis
Grzegorz
G
Jedynak-Wasowicz
Urszula
U
Pietrzyk
Jacek Józef
JJ
Lange
Joanna
J
Małaczyńska
Teresa
T
Kraluk
Barbara
B
Swiebocka
Ewa
E
Breborowicz
Anna
A
Kycler
Zdzisława
Z
Pietraszek-Mamcarz
Jolanta
J
Poszwiński
Adam
A
Gaszczyk
Grzegorz
G
D002648:Child; D003888:Desensitization, Immunologic / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006633:Histamine Antagonists / Q000008:administration & dosage; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000201:enzymology / Q000276:immunology / Q000517:prevention & control*; D007073:Immunoglobulin E / Q000378:metabolism; D007299:Insect Bites and Stings / Q000150:complications*; D011044:Poland; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D011292:Premedication; D053802:Tryptases / Q000378:metabolism
D006633:Histamine Antagonists; D007073:Immunoglobulin E; D053802:Tryptases