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Follow-Up of Hymenoptera-Sensitive Patients Without Active Immunotherapy

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Presently there is no definitive guideline for the treatment of adult patients suffering from generalized insect sting reactions limited to skin manifestations or purely respiratory compromise who have not been treated with immunotherapy. Previous studies in adults demonstrate that the majority of patients with insect sting anaphylaxis have a decreased reactivity to re-sting with time, suggesting the insect allergy itself may be self-limiting. In this study, we evaluated 63 patients with initial insect sting manifestations limited to the skin and the respiratory system and noted the incidence and degree of natural re-sting reactions to these patients who had not undergone venom immunotherapy. In those patients with mild systemic reactions limited to the skin, none experienced an increase in severity. A local reaction was found on repeat sting in three of five patients in this group, and two of five had an equivalent cutaneous response (i.e., urticaria/angioedema). In five patients who had an initial respiratory reaction, four of the patients had a local reaction while one patient repeated the same respiratory manifestations. None of the patients with cutaneous or respiratory symptoms demonstrated a more severe reaction upon re-sting. This demonstrates that there is a natural progression of tolerance to insect stings in the adult population.
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Document Type: Research Article

Publication date: 1994-03-01

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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