In a child of a beekeeping family anaphylaxis developed after a honey-bee sting. He was treated with the conventional therapy, whole-(insect)-body extracts, for nine months. A second sting caused anaphylaxis again. Since the patient's family history included a sister who had died in similar circumstances, he was immunized with 1.4 mg of honey-bee venom over a two-month period; the last two doses were 100 μg (≅ two bee stings). His sensitivity to venom, assessed by basophil histamine release, decreased, and his blocking (IgG) antibody level increased 300 times over that after immunization with whole-body extract. After venom immunization he tolerated a honey-bee sting without reaction. The case and a review of pertinent data suggest that venom immunization may be the treatment of choice for hymenoptera sensitivity. (N Engl J Med 290:1223–1227, 1974), ANAPHYLACTIC reactions to stings by bees, wasps and hornets represent an important medical problem. Although they are reported as the cause of relatively few deaths, the dimension of the problem is better appreciated from the observation that 0.4 to 0.8 per cent of various population samples have a history of a systemic reaction after an insect sting.
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