title: Self-medication of anaphylactic reactions due to Hymenoptera stings-an EAACI Task Force Consensus Statement.
abstract: An anaphylactic reaction due to a Hymenoptera sting is a clinical emergency, and patients, their caregivers as well as all healthcare professionals should be familiar with its recognition and acute management. This consensus report has been prepared by a European expert panel of the EAACI Interest Group of Insect Venom Hypersensitivity. It is targeted at allergists, clinical immunologists, internal medicine specialists, pediatricians, general practitioners, emergency department doctors, and any other healthcare professional involved. The aim was to report the scientific evidence on self-medication of anaphylactic reactions due to Hymenoptera stings, to inform healthcare staff about appropriate patient self-management of sting reactions, to propose indications for the prescription of an adrenaline auto-injector (AAI), and to discuss other forms of medication. First-line treatment for Hymenoptera sting anaphylaxis is intramuscular adrenaline. Prescription of AAIs is mandatory in the case of venom-allergic patients who suffer from mast cell diseases or with an elevated baseline serum tryptase level and in untreated patients with a history of a systemic reaction involving at least two different organ systems. AAI prescription should also be considered in other specific situations before, during, and after stopping venom immunotherapy.
authors.affiliation: Allergy Unit, Department of Internal Medicine, University Hospital, Ancona, Italy.
authors.forename: M B
authors.initials: MB
authors.lastname: Bilò
authors.affiliation: Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Cichocka-Jarosz
authors.affiliation: Immunology, Central Manchester University Hospitals, Manchester, UK.
authors.forename: R
authors.initials: R
authors.lastname: Pumphrey
authors.affiliation: Department of Allergology, GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: J N
authors.initials: JN
authors.lastname: Oude-Elberink
authors.affiliation: Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Lange
authors.affiliation: Department of Dermatology and Allergology, Justus Liebig University Gießen, University Medical Center Gießen and Marburg GmbH, Gießen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Jakob
authors.affiliation: Allergy Unit, Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Bonadonna
authors.affiliation: Allergy Service, Department of Clinical Medicine, Alicante University Hospital, UMH, Alicante, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Fernandez
authors.affiliation: University Clinic of Respiratory and Allergic Disease, Golnik, Slovenia.
authors.forename: M
authors.initials: M
authors.lastname: Kosnik
authors.affiliation: Division of Allergology, University Clinic of Rheumatology, Immunology and Allergology, University Hospital/Inselspital, Bern, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Helbling
authors.affiliation: Allergy Unit, Department of Dermatology and Allergy, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Mosbech
authors.affiliation: Department of Internal Medicine, Allergy and Clinical Immunology, Silesian University of Medicine, Katowice, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Gawlik
authors.affiliation: Department of Allergology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Niedoszytko
authors.affiliation: Division and School of Allergy and Clinical Immunology, ASL Salerno and University of Naples Federico II, Naples, Battipaglia Hospital, Salerno, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Patella
authors.affiliation: Clinical Allergy and Immunology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Pravettoni
authors.affiliation: Allergy and Clinical Immunology Division, Divino Espirito Santo Hospital, Ponta Delgada, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Rodrigues-Alves
authors.affiliation: Ambulatory for Allergy and Clinical Immunology, Vienna, Austria.|Department of Dermatology, Medical University of Graz, Graz, Austria.
authors.forename: G J
authors.initials: GJ
authors.lastname: Sturm
authors.affiliation: Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Rueff
mesh_terms: D000485:Allergens / Q000276:immunology*; D000707:Anaphylaxis / Q000209:etiology* / Q000628:therapy*; D000818:Animals; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D007279:Injections, Subcutaneous; D007299:Insect Bites and Stings / Q000150:complications*; D012651:Self Medication / Q000379:methods
chemical_list: D000485:Allergens; D004837:Epinephrine
keywords: adrenaline; anaphylaxis; hymenoptera; immunotherapy; insect venom allergy