Diagnosis of hymenoptera venom sensitivity

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of review: The objective of this review is to highlight recent advances in the preparation, documentation and performance of reagents and methods used in the diagnosis of Hymenoptera-venom-induced immediate-type hypersensitivity. Recent findings: The following potent allergens have been reported: (1) a low-molecular-weight honey-bee allergen (Api m 6) has been described; (2) venom allergens in the North American species of bumble-bee (Bombus pennsylvanicus) have been more fully characterized, with the focus on phospholipase A2; (3) the vespid venom Ves v 5 allergen has been structurally mapped to identify immunoglobulin-E-binding epitopes; (4) the possible role of carbohydrate antigen epitopes as a cause of cross-reactivity among honey-bee and vespid venom proteins has been reported; and (5) the venom of Pachycondyla chinensis, an ant found commonly in the Far East, has been decribed. The most significant reports during this period have focused on the less-than-ideal performance of the intradermal venom skin-test reagents. The issue of the patient that is positive for venom allergy history but negative for an intradermal venom skin test is raised, and it is suggested that there is a need for caution and the use of serology as a supplementary diagnostic test. Summary: The important issue this year is the reminder that intradermal skin tests may be negative in venom-allergic patients, possibly because of changes in the potency of the extracts. The clinical history should drive the diagnosis of insect-sting allergy. When negative confirmatory venom skin-test or serology results are considered to be inconsistent with a positive history, they should be repeated.

Original languageEnglish (US)
Pages (from-to)347-351
Number of pages5
JournalCurrent opinion in allergy and clinical immunology
Volume2
Issue number4
DOIs
StatePublished - Aug 2002

Keywords

  • Diagnosis
  • Hymenoptera venom
  • Skin test
  • Sting-challenge provocation test
  • Venom-specific immunoglobulin E antibody

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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