Venom Immunotherapy

Questions and controversies regarding venom immunotherapy (VIT) remain. It is important to recognize risk factors for severe sting anaphylaxis that guide the recommendation for testing, epinephrine injectors, and VIT. Premedication, rush VIT, and omalizumab are successful in overcoming recurrent systemic reactions to VIT. A maintenance dose is adequate in children, but higher doses are needed in high-risk patients. The consensus on risk of β-blockers and angiotensin-converting enzyme inhibitors in patients on VIT has shifted to the belief that risk is small. The decision to stop VIT after 5 years rests on known risk factors rather than any diagnostic tests.
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research

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Abstract Stinging insect allergy is uncommon but can be life threatening. Diagnosis requires clinical history and confirmative skin or blood testing by an allergist. Baseline serum tryptase level can be used to stratify risk. Treatment is supportive for all reactions except for anaphylaxis, which is treated with intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids, and oxygen. Venom immunotherapy is most effective for long-term management in patients with a history of anaphylaxis. Venom immunotherapy rapidly reduces the risk of sting anaphylaxis by up to 98% and maintenance treatmen...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Med Clin North Am Source Type: research
Stinging insect allergy is uncommon but can be life threatening. Diagnosis requires clinical history and confirmative skin or blood testing by an allergist. Baseline serum tryptase level can be used to stratify risk. Treatment is supportive for all reactions except for anaphylaxis, which is treated with intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids, and oxygen. Venom immunotherapy is most effective for long-term management in patients with a history of anaphylaxis. Venom immunotherapy rapidly reduces the risk of sting anaphylaxis by up to 98% and maintenance treatment can be stopped a...
Source: Medical Clinics of North America - Category: Primary Care Authors: Source Type: research
Authors: Bilò MB, Tontini C, Martini M, Corsi A, Agolini S, Antonicelli L Abstract Summary: Hymenoptera venom allergy (HVA) is the most frequent cause of anaphylaxis in Europe, accounting for most of the severe reactions occurring in adults, and being the second cause of anaphylaxis in children. Prevention of further episodes in patients who developed a systemic reaction (SR) is based on the correct management of the allergic emergency, the referral to an allergist for a correct diagnosis, prescription of adrenaline auto-injectors (AAI) and specific venom immunotherapy (VIT), if recommended. Diagnosis is bas...
Source: European Annals of Allergy and Clinical Immunology - Category: Allergy & Immunology Tags: Eur Ann Allergy Clin Immunol Source Type: research
Purpose of review Guidelines on insect sting allergy and venom immunotherapy (VIT) have been updated. This review describes the evolution of these guidelines and their similarities and differences. Recent findings The US and European guidelines show the evolution of guideline development in the grading of recommendations and the transparency of the evaluation of evidence. The US and European guidelines on VIT are similar in most areas and complimentary in others. The European guidelines are limited to VIT and are based on a published systematic review; the US practice parameters cover all areas of the diagnosis and ma...
Source: Current Opinion in Allergy and Clinical Immunology - Category: Allergy & Immunology Tags: ANAPHYLAXIS AND INSECT ALLERGY: Edited by Gianenrico Senna and Mariana Castells Source Type: research
Hymenoptera stings may cause both local and systemic allergic reactions and sometimes even life threatening anaphylaxis. Along with pharmaceutical drugs and foods, hymenoptera venom is one of the most common causes of anaphylaxis in humans. To date, no parameter has been identified that may predict which sensitized people will have a future anaphylactic reaction, however many risk factors such as mast cell activation syndromes associated with the severity of the re-sting reaction are known. Venom immunotherapy (VIT) is the most effective method of treatment for people who had systemic reactions to an insect sting, which is...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: In the most important procedures, there is a very high compliance with the guidelines. In the areas where the guidelines are not precise, we observed a large spread of results. PMID: 31333352 [PubMed]
Source: Advances in Dermatology and Allergology - Category: Dermatology Tags: Postepy Dermatol Alergol Source Type: research
Conclusions: The treatment after the sting in a significant percentage of episodes still deviates from the recommendations of the guidelines, especially in the field of adrenaline recommendations for patients in case of a resting by an insect. PMID: 31333347 [PubMed]
Source: Advances in Dermatology and Allergology - Category: Dermatology Tags: Postepy Dermatol Alergol Source Type: research
Publication date: April 2019Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 7, Issue 4Author(s): David B.K. Golden, Melody C. CarterInsect sting anaphylaxis and mast cell disorders are intertwined in a specific and unusual way. There may be specific subsets of clonal mast cell disorders that are predisposed to sting anaphylaxis. The clinical characteristics of the sting reactions should raise suspicion of underlying mastocytosis (eg, hypotension without hives especially in a male). A baseline serum tryptase level is helpful in the evaluation of patients with insect sting anaphylaxis because it c...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
CONCLUSIONS: The gender, treatment duration and stage of anaphylactic reaction influenced level of anxiety. The level of feeling of safety was related to the place of living. PMID: 30922038 [PubMed - in process]
Source: Annals of Agricultural and Environmental Medicine : AAEM - Category: Environmental Health Authors: Tags: Ann Agric Environ Med Source Type: research
The basis of venom immunotherapy (VIT) can be defined as protection against IgE-mediated immunologic mechanisms such as anaphylaxis.1,2 Most insect stings produce local reactions of swelling, pain, erythema and pruritus, typically peaking by 24-48 hours and resolving within 3-10 days.5 Unfortunately, some patients experience systemic reactions ranging from cutaneous reactions only (characterized by urticaria and/or angioedema, excluding throat, larynx and tongue) to life-threatening systemic anaphylactic reactions (SAR).
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Letters Source Type: research
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