[Diagnosis and treatment of insect venom allergy. An important allergic issue for the ear, nose and throat specialist].

Abstract

The increasing incidence and the potentially life-threatening reactions to venom stings indicate the necessity for otolaryngologists to have a basic knowledge of the diagnosis and treatment of venom allergy. The diagnosis of insect venom allergy is based on the history, skin prick testing (ideally performed as a titration series), and in vitro analysis of specific IgE antibodies to venoms. An emergency medication kit should be prescribed for the patient in case of future venom stings, comprising an H1-blocking antihistamine, a steroid and an adrenaline pen for self-injection. Subcutaneous allergen-specific immunotherapy (sSIT) is the standard treatment to avoid allergic reactions following venom stings in the future. SIT is indicated following all immediate-type reactions to venom stings; contraindications relate to the general recommendations of allergen-specific immunotherapy. Aqueous as well as alum-adsorbed depot allergen preparations can be used for subcutaneous injections. The important dose-increase phase can be performed using conventional, cluster, rush or ultra-rush schedules. Specific immunotherapy is successful in nearly 90% to 100% of patients after 3-5 years of treatment.

• Authors: O Pfaar, L Klimek, I Hansen, B A Stuck, K Hörmann
• Journal: HNO (HNO) Vol. 53 Issue 12 Pg. 1099-115 (Dec 2005) ISSN: 0017-6192 [Print] Germany
• Vernacular Title: Diagnostik und Therapie der Insektengiftallergie. Eine wichtige Aufgabe auch für den allergologisch tätigen HNO-Arzt.
• PMID: 16283132 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Arthropod Venoms

Topics

• Arthropod Venoms (poisoning)
• Critical Care (methods)
• Humans
• Hypersensitivity (diagnosis, therapy)
• Insect Bites and Stings (diagnosis, therapy)
• Otolaryngology (methods)
• Practice Guidelines as Topic
• Practice Patterns, Physicians'