title: Added sensitivity of component-resolved diagnosis in hymenoptera venom-allergic patients with elevated serum tryptase and/or mastocytosis.
abstract: Anaphylaxis caused by hymenoptera venom allergy is associated with elevation of baseline serum tryptase (sBT) and/or mastocytosis in about 5% of patients. Up to now, no information has become available on single venom allergen sIgE reactivity and the usefulness of component-resolved approaches to diagnose this high-risk patient group. To address the component-resolved sIgE sensitization pattern and diagnostic sensitivity in hymenoptera venom-allergic patients with elevated sBT levels and/or mastocytosis, a panel of yellow jacket and honeybee venom allergens was applied on a widely used IgE immunoassay platform.
  
  
  
  Fifty-three patients with mastocytosis and/or elevated sBT tryptase level and systemic reactions to hymenoptera venoms were analyzed for their IgE reactivity to recombinant yellow jacket and honeybee venom allergens by Immulite3 g.
  
  
  
  sIgE reactivity to Ves v 1, Ves v 5, Api m 1 to Api m 4 and Api m 10 was found at a similar frequency in hymenoptera venom-allergic patients with and without elevated sBT levels and/or mastocytosis. However, the use of the recombinant allergens and a diagnostic cutoff of 0.1 kUA /L allowed the diagnosis of patients with otherwise undetectable IgE to venom extract. The diagnostic sensitivity of yellow jacket venom allergy using the combination of Ves v 1 and Ves v 5 was 100%.
  
  
  
  In high-risk patients with elevated sBT levels and/or mastocytosis, the use of molecular components and decreasing the threshold sIgE level to 0.1 kUA /L may be needed to avoid otherwise undetectable IgE to hymenoptera venom extracts in about 8% of such patients.
authors.affiliation: Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Michel
authors.affiliation: Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Brockow
authors.affiliation: Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Darsow
authors.affiliation: Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Ring
authors.affiliation: Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany.|Member of the German Center of Lung Research (DZL), Hamburg, Germany.
authors.forename: C B
authors.initials: CB
authors.lastname: Schmidt-Weber
authors.affiliation: PLS-Design GmbH Hamburg, Hamburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Grunwald
authors.affiliation: Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Blank
authors.affiliation: Department of Infection and Immunity, Luxembourg Institute of Health (LIH), Esch-sur-Alzette, Luxembourg.|Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Ollert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology*; D000818:Animals; D000918:Antibody Specificity / Q000276:immunology; D001180:Arthropod Venoms / Q000276:immunology*; D015415:Biomarkers; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D008415:Mastocytosis / Q000097:blood* / Q000175:diagnosis; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D053802:Tryptases / Q000097:blood*; D055815:Young Adult
chemical_list: D000485:Allergens; D001180:Arthropod Venoms; D015415:Biomarkers; D007073:Immunoglobulin E; D053802:Tryptases
keywords: component-resolved diagnosis; diagnostic sensitivity; hymenoptera venom allergy; mastocytosis; serum tryptase