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Fatal Reactions to Hymenoptera Stings

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Abstract:

Previous studies measuring immunoglobulin E (IgE) antibodies in postmortem sera for determining the cause of fatal anaphylaxis have reported only single cases or small groups. Recently, more attention has been paid to reports of patients with venom allergies who are negative by venom skin testing, by in vitro testing or by both tests. The aim of this study was to determine the reliability of postmortem-specific IgE antibody testing in venom anaphylactic death and the range of antibody levels found. Radioallergosorbent testing was performed on sera from three groups: 51 anaphylactic deaths from insect stings, 20 anaphylactic/anaphylactoid deaths from food and drugs, and 31 control subjects. Results were analyzed by descriptive statistics, chi-squared test, and receiver operating characteristic curve. The sera in the sting death group were significantly different from the other two groups, which were not statistically different from each other. The maximal sensitivity of the radioallergosorbent test was 90% at 0.35 ng/mL, and the optimal sensitivity was 73% with a specificity of 86% at 0.54 ng/mL. IgE antibody could not be detected in 10% of the sting death sera and levels from 0.35 to 0.65 ng/mL were found in 24%. The level of specific IgE antibodies against venoms is not predictive of the severity of anaphylactic reaction.

Document Type: Original Article

Publication date: March 1, 2003

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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