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Otorhinolaryngology
Allergology Review



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  Authority of Polish Society of Allergology




vol 13. no 3. September 2008  
 TABLE OF CONTENT

 Original articles
Hypersensitivity reactions to hymenoptera venom: clinical patterns and biphase reactions
EWA SMORAWSKA-SABANTY, MAREK L. KOWALSKI

Introduction. Patients with generalized reactions to a hymenoptera sting require special medical attention due to the high-severity of reactions and the risk of death.
Aim of the study. This study attempts to provide a clinical analysis of hymenoptera sting hypersensitivity with special regard to reaction dynamics occurring after the sting.
Material and methods. 272 patients were enrolled in the study after being referred to allergology centre following hymenoptera stings. The analysis was based on data compiled using the Mueller questionnaire and on results of skin prick tests for inhaled allergens.
Results. A generalised reaction to stings occurred in 242 patients (89%) and large local reaction in 30 patients (11%). The severity of the generalized reaction was not related to the sex or age of the patients, or to the insect type. Mueller grade IV symptoms occurred in 69 (28.5%) of the patients with a generalized reaction, including 25 patients (10.2%) suffering a loss of consciousness. In 20 patients (7.4%), a biphase reaction was observed – regression or mitigation of symptoms followed by their recurrence. No significant correlation was observed between reaction phasing and reaction severity, insect type, sex or age of the patient or atopic features. The results of the skin prick tests for inhaled allergens showed that out of 214 patients, 139 (65%) revealed a positive result to at least one allergen.
Conclusions. The clinical pictures of allergic reactions to bee and wasp stings are similar and the presence of atopic features does not predispose to severe reaction to stings. Patients with a generalised reaction to a sting should be hospitalised, since 7.4% of them may have a biphase reaction.


keywords: alergia na jad owadów, anafilaksja, insect sting allergy, anaphylaxis

pages: from 151 to 160



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