Insect Allergy

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Systemic reactions to insect stings are reported by 3% of adults and can be fatal even on the first reaction. Large local reactions are more frequent than systemic reactions, but rarely dangerous. The chance of a systemic reaction to a sting is low (5-10%) in children and adults with a history of large local reactions and in children with mild (cutaneous) systemic reactions, and varies between 30% and 65% in adults with previous systemic reactions, depending on the severity of previous sting reactions. Venom sensitization can be detected in 20% of normal adults, so the history is most important in clinical evaluation. Venom skin tests are most sensitive for diagnosis but the serum-specific IgE test is an important complementary test. The level of venom-IgE detected by the skin test or serum test does not, however, reliably predict the severity of a sting reaction. Baseline serum tryptase is elevated in many patients with sting anaphylaxis, and should be evaluated as a predictor of severe reactions. Venom immunotherapy is safe and is 75-98% effective in preventing sting anaphylaxis; it also significantly reduces the risk of large local reactions. Most patients can discontinue treatment after 5 years, with very low residual risk of a severe sting reaction.

Original languageEnglish (US)
Title of host publicationMiddleton's Allergy Essentials: First Edition
PublisherElsevier Inc.
Pages377-393
Number of pages17
ISBN (Print)9780323392730, 9780323375795
DOIs
StatePublished - Jan 26 2016

Fingerprint

Bites and Stings
Insects
Hypersensitivity
Venoms
Anaphylaxis
Skin Tests
Immunoglobulin E
Serum
Insect Bites and Stings
Tryptases
Immunotherapy
History
Skin

ASJC Scopus subject areas

  • Medicine(all)
  • Immunology and Microbiology(all)

Cite this

Golden, D. B. K. (2016). Insect Allergy. In Middleton's Allergy Essentials: First Edition (pp. 377-393). Elsevier Inc.. https://doi.org/10.1016/B978-0-323-37579-5.00015-5

Insect Allergy. / Golden, David B K.

Middleton's Allergy Essentials: First Edition. Elsevier Inc., 2016. p. 377-393.

Research output: Chapter in Book/Report/Conference proceedingChapter

Golden, DBK 2016, Insect Allergy. in Middleton's Allergy Essentials: First Edition. Elsevier Inc., pp. 377-393. https://doi.org/10.1016/B978-0-323-37579-5.00015-5
Golden DBK. Insect Allergy. In Middleton's Allergy Essentials: First Edition. Elsevier Inc. 2016. p. 377-393 https://doi.org/10.1016/B978-0-323-37579-5.00015-5
Golden, David B K. / Insect Allergy. Middleton's Allergy Essentials: First Edition. Elsevier Inc., 2016. pp. 377-393
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