Local and extensive reactions due to Hymenoptera sting: Its relationship to systemic reactions

Abstract

Introduction

Hymenoptera stings (Hs) can cause allergic reactions to Hymenoptera venom (HV), both local and systemic. There is controversy regarding the risk of developing an HV-systemic reaction (HV-SR) after one or several previous extensive local allergic reactions (ELAR) due to HV.

Objectives

To evaluate the risk of HV-SR in patients who have suffered at least one previous ELAR due to HV, the relevance of sensitization to HV for suffering from SR-HV in the future, and the prevalence of sensitization to inhalants and foods.

Methods

A descriptive retrospective (first phase, years: 2000–2015) and prospective (second phase, years: 2016–2023) study were conducted with patients ELAR. We periodically reviewed the patients to detect HV-SR, sensitizations, and personal histories of ELAR.

Results

We examined 281 patients with ELAR to see if they had had HV-SR but detected only 2 patients with HV-SR. In the second phase, only 3 patients with HV-SR had a history of ELAR. HV-specific IgE was determined in 224 patients, of which 146 were sensitized to at least one HV. Using skin prick tests, we detected 54 patients sensitized to pollen and sensitized food to 8 patients.

Conclusion

Patients with ELAR due to an Hs have little chance of developing SR-HV, even though 2/3 of patients are sensitized to at least one HV. Atopic load is irrelevant for suffering a future HV-RS.