Current Opinion in Allergy and Clinical Immunology
Anaphylaxis and insect allergy: Edited by Theodore Freeman, Jacobs, Ramirez, and Freeman Allergy & Immunology Associates and Alessandro Fiocchi
Department of Internal Medicine, Immunology, Allergy and Respiratory Diseases, Azienda Ospedaliero-Universitaria, Ospedali Riuniti, Ancona, Italy
Correspondence to Beatrice M. Bilò, Department of Internal Medicine, Immunology, Allergy and Respiratory Diseases, Azienda Ospedaliero-Universitaria, Ospedali Riuniti, Ancona, Italy Tel: +39 071 5963804; fax: +39 071 5963253; e-mail: [email protected]
Current Opinion in Allergy and Clinical Immunology 8(4):p 330-337, August 2008. | DOI: 10.1097/ACI.0b013e32830638c5
Abstract
Purpose of review
Knowledge of the epidemiology, natural history and risk factors of insect-venom allergy is crucial for improving the clinical management of allergic patients. This review focuses on the recent research on these aspects of Hymenoptera-sting anaphylactic reactions.
Recent findings
The latest data from population-based studies of anaphylactic reactions due to Hymenoptera stings, as well as those extrapolated from studies of epidemiology of anaphylaxis due to any cause are reviewed. The topic of biphasic anaphylactic reactions due to insect stings is also examined. Although no parameter has been identified that can predict which sensitized individuals will have a future anaphylactic reaction, several factors associated with the severity of a systemic resting reaction are known and emphasized here.
Summary
As half of individuals with fatal sting reactions had no documented history of previous systemic reaction, we need to further improve the knowledge of the natural history and risk factors, especially in asymptomatic-sensitized individuals. Moreover, and no less important, the epidemiological studies on sting anaphylaxis conducted in the 2000s continue to reveal the poor management of allergic patients and the startling lack of awareness of the efficacy of venom immunotherapy. These findings indicate the urgent need to educate the general population and doctors on the management of venom-allergic patients.