Stinging insect allergy and venom immunotherapy

2019 ◽  
Vol 40 (6) ◽  
pp. 372-375
Author(s):  
Elisa N. Ochfeld ◽  
Paul A. Greenberger
Keyword(s):  
Local Reaction ◽  
Paper Wasp ◽  
Positive Skin ◽  
Yellow Jacket ◽  
Bee Sting ◽  
Insect Allergy ◽  
History Of ◽  
Patient Groups ◽  
Stinging Insect ◽  
African Honeybee

The Hymenoptera order is divided into three families: Apidae, Vespidae, and Formicidae. Apidae include the honeybee, bumblebee, and sweat bee, which are all docile and tend to sting mostly on provocation. The Africanized killer bee, a product of interbreeding between the domestic and African honeybee, is very aggressive and is mostly found in Mexico, Central America, Arizona, and California. The yellow jacket, yellow hornet, white (bald) faced hornet, and paper wasp all belong to the Vespidae family. The Formicidae family includes the harvester ant and the fire ant. When a “bee” sting results in a large local reaction, defined as >10 cm induration and lasting > 24 hours, the likelihood of anaphylaxis from a future sting is approximately 5%. For comparison, when there is a history of anaphylaxis from a previous Hymenoptera sting and the patient has positive skin test results to venom, at least 60% of adults and 20‐32% of children will develop anaphylaxis with a future sting. Both patient groups should be instructed about avoidance measures and about carrying and knowing when to self-inject epinephrine, but immunotherapy with Hymenoptera venom is indicated for those patients with a history of anaphylaxis from the index sting and not for patients who have experienced a large local reaction. Immunotherapy is highly effective in that, by 4 years of injections, the incidence of subsequent sting-induced reactions is 3%. This incidence may increase modestly after discontinuation of injections but has not been reported to be > 10% in follow up.

Antibody binding to venom carbohydrates is a frequent cause for double positivity to honeybee and yellow jacket venom in patients with stinging-insect allergy

2001 ◽  
Vol 108 (6) ◽  
pp. 1045-1052 ◽  
Author(s):  
Wolfgang Hemmer ◽  
Margarete Focke ◽  
Daniel Kolarich ◽  
Iain B.H. Wilson ◽  
Friedrich Altmann ◽  
...  
Keyword(s):  
Antibody Binding ◽  
Yellow Jacket ◽  
Insect Allergy ◽  
Stinging Insect ◽  
Yellow Jacket Venom

Sequential degranulation of eosinophils induced by antigen or autocoids in allergic humans

1986 ◽  
Vol 44 ◽  
pp. 354-355
Author(s):  
Kate W. Sjoerdsma ◽  
W. James Metzger
Keyword(s):  
Allergic Rhinitis ◽  
Bronchoalveolar Lavage ◽  
Allergic Asthma ◽  
Skin Test ◽  
Positive Skin Test ◽  
Positive Skin ◽  
Human Eosinophil ◽  
Asthmatic Patients ◽  
Allergic Asthmatic ◽  
History Of

Eosinophils are important to the pathogenesis of allergic asthma, and are increased in bronchoalveolar lavage within four hours after bronchoprovocation of allergic asthmatic patients, and remain significantly increased up to 24 hours later. While the components of human eosinophil granules have been recently isolated and purified, the mechanisms of degranulation have yet to be elucidated.We obtained blood from two volunteers who had a history of allergic rhinitis and asthma and a positive skin test (5x5mm wheal) to Alternaria and Ragweed. Eosinophils were obtained using a modification of the method described by Roberts and Gallin.

High Rate of Negative Results of Tuberculin and QuantiFERON Tests Among Individuals With a History of Positive Skin Test Results

2006 ◽  
Vol 27 (5) ◽  
pp. 436-441 ◽  
Author(s):  
Lloyd N. Friedman ◽  
Esther R. Nash ◽  
June Bryant ◽  
Susan Henry ◽  
Julia Shi ◽  
...  
Keyword(s):  
Skin Test ◽  
Significant Proportion ◽  
High Rate ◽  
Negative Group ◽  
Tuberculosis Screening ◽  
Positive Skin ◽  
Screening Programs ◽  
History Of ◽  
Positive Results

Objectives.To evaluate individuals at high risk for tuberculosis exposure who had a history of a positive tuberculin skin test (TST) result in order to determine the prevalence of unsuspected negative TST results. To confirm these findings with the QuantiFERON-TB test (QFT), an in vitro whole-blood assay that measures tuberculin-induced secretion of interferon-γ.Methods.This survey was conducted from November 2001 through December 2003 at 3 sites where TST screening is regularly done. Detailed histories and reviews of medical records were performed. TSTs were placed and read by 2 experienced healthcare workers, and blood was drawn for QFT. Any subject with a negative result of an initial TST during the study (induration diameter, <10 mm) underwent a second TST and a second QFT. The TST-negative group comprised individuals for whom both TSTs had an induration diameter of <10 mm. The confirmed-negative group comprised individuals for whom both TSTs yielded no detectable induration and results of both QFTs were negative.Results.A total of 67 immunocompetent subjects with positive results of a previous TST were enrolled in the study. Of 56 subjects who completed the TST protocol, 25 (44.6%; 95% confidence interval [CI], 31.6%-57.6%) were TST negative (P<.001). Of 31 subjects who completed the TST protocol and the QFT protocol, 8 (25.8%; 95% CI, 10.4%-41.2%) were confirmed negative (P<.005).Conclusions.A significant proportion of subjects with positive results of a previous TST were TST negative in this study, and a subset of these were confirmed negative. These individuals' TST status may have reverted or may never have been positive. It will be important in future studies to determine whether such individuals lack immunity to tuberculosis and whether they should be considered for reentry into tuberculosis screening programs.

Penicillin Hypersensitivity

1979 ◽  
Vol 1 (5) ◽  
pp. 132-158
Keyword(s):  
Skin Test ◽  
Multicenter Study ◽  
Positive Skin Test ◽  
Penicillin Allergy ◽  
Skin Tests ◽  
Penicillin G ◽  
Positive Skin ◽  
Positive History ◽  
History Of

A (massive) multicenter study of 3,000 patients has demonstrated that skin tests to penicillin G and penicilloyl-polylysine (PPL-now commercially available) predict and confirm penicillin allergy. Of patients with a history of penicillin reaction, 19% were positive to either, compared to 7% of controls. A history of anaphylaxis led to 46% positive. Of those with a history of urticaria 17% were positive, and those with maculopapular eruptions did not differ from controls (7% positive). Challenge with penicillin led to a reaction in 6% with a positive history (compared to 2% with a negative) and 67% with a combined positive history and positive skin test (to either).

Allergy Questions and Answers

2013 ◽  
pp. 105-108
Author(s):  
Robert D. Ficalora
Keyword(s):  
Drug Allergy ◽  
Multiple Choice ◽  
Allergic Diseases ◽  
Questions And Answers ◽  
Asthma Drug ◽  
Insect Allergy ◽  
Stinging Insect ◽  
Board Review ◽  
Seasonal Allergies

Chapter 11 presents multiple-choice, board review questions on allergic diseases including seasonal allergies, angioedema, anaphylaxis, asthma, drug allergy, and stinging insect allergy. Full explanations are provided with the correct answers.

Allergy and Immunology

2020 ◽  
pp. 235-249
Author(s):  
Elizabeth Lippner ◽  
Sean A. McGhee
Keyword(s):  
Primary Immunodeficiency ◽  
Atopic Diseases ◽  
Primary Immunodeficiency Diseases ◽  
Immunodeficiency Diseases ◽  
Allergy And Immunology ◽  
Insect Allergy ◽  
Stinging Insect ◽  
Allergic Disorders ◽  
Answer Format

The chapter on allergy and immunology reviews the risk factors, clinical presentation, diagnostic evaluation, and management of atopic diseases and immunodeficiency diseases. The material is presented in an engaging clinical vignette and question-and-answer format. The key medical conditions covered in the chapter include allergic and atopic diseases such as asthma, food allergy, anaphylaxis, urticaria/angioedema, drug allergy, and stinging insect allergy; it also touches on rarer primary immunodeficiency diseases. It highlights key clinical features to enable differentiation of allergic disorders from their mimickers; it provides a diagnostic approach to evaluate primary immunodeficiency diseases, and it covers both acute/urgent and long-term disease management.

Parvovirus Infection in a Child Presenting with Erythema Multiforme and Vasculitis after a Yellow Jacket Bee Sting

2020 ◽  
Author(s):  
Ceren Can ◽  
Mehtap Yazicioglu ◽  
Selman Gokalp ◽  
Nese Ozkayin
Keyword(s):  
Erythema Multiforme ◽  
Wide Spectrum ◽  
Parvovirus B19 ◽  
Clinical Manifestations ◽  
Yellow Jacket ◽  
Systemic Reactions ◽  
Bee Sting ◽  
Life Threatening ◽  
Insect Stings ◽  
Parvovirus B 19

Abstract Parvovirus B19 has a wide spectrum of clinical manifestations. Erythema multiforme and vasculitis are rarely reported with parvovirus B19 infections. Reactions to insect stings can range from local swelling to life-threatening systemic reactions. There have been rare reports of unusual reactions, such as vasculitis, occurring in a temporal relationship with insect stings. We report an 8-year-old patient having Parvovirus B-19-related erythema multiforme and vasculitis after a yellow jacket bee sting.

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