Pages Menu
TwitterRssFacebook
Categories Menu

Posted by on Jun 14, 2013 in Medical Journals |

Mastocytosis and insect venom allergy.

Head for The Masto Townhall forum to debate this paper.
This article may be copyrighted. Notice to copyright holders.
You can view the full article at the publisher here
There is a fee associated with downloading this article.
Curr Opin Allergy Clin Immunol. 2010 Aug;10(4):347-53. doi: 10.1097/ACI.0b013e32833b280c.

Mastocytosis and insect venom allergy.

Bonadonna P, Zanotti R, Müller U.

Abstract

PURPOSE OF REVIEW:

To analyse the association of systemic allergic hymenoptera sting reactions with mastocytosis and elevated baseline serum tryptase and to discuss diagnosis and treatment in patients with both diseases.

RECENT FINDINGS:

In recent large studies on patients with mastocytosis a much higher incidence of severe anaphylaxis following hymenoptera stings than in the normal population was documented. In patients with hymenoptera venom allergy, elevated baseline tryptase is strongly associated with severe anaphylaxis. Fatal sting reactions were reported in patients with mastocytosis, notably after stopping venom immunotherapy. During venom immunotherapy most patients with mastocytosis are protected from further sting reactions. Based on these observations immunotherapy for life is recommended for patients with mastocytosis and venom allergy. The incidence of allergic side-effects is increased in patients with mastocytosis and elevated baseline tryptase, especially in those allergic to Vespula venom. Premedication with antihistamines, or omalizumab in cases with recurrent severe side-effects, can be helpful.

SUMMARY:

In all patients with anaphylaxis following hymenoptera stings, baseline serum tryptase should be determined. A value above 11.4 microg/l is often due to mastocytosis and indicates a high risk of very severe anaphylaxis following re-stings. Venom immunotherapy is safe and effective in this situation.

PMID: 20485157 [PubMed – indexed for MEDLINE]