The value of immunotherapy with venom in children with allergy to insect stings

Martin D. Valentine, Kenneth C Schuberth, Anne Kagey-Sobotka, David F. Graft, Kathy A. Kwiterovich, Moyses Szklo, Lawrence M. Lichtenstein

Research output: Contribution to journalArticle

Abstract

Background. The treatment of patients allergic to insect stings with insect-venom injections has been shown to be 97 percent effective in reducing the risk of sting-induced anaphylaxis. However, the frequency of systemic reactions to subsequent stings in unimmunized adults with previous reactions is approximately 60 percent. To determine which factors, in addition to a history of reaction and evidence of venom-specific IgE antibody, predispose patients to future insect-sting reactions, we studied a venom-sensitive group of children who were deemed to be at relatively low risk for severe reactions; 28 percent of them received venom therapy. Methods. We studied 242 children, 2 through 16 years of age, each of whom had had a systemic allergic reaction, affecting only the skin, to an insect sting. Each child had a positive skin-test reaction to one or more of five hymenopteran venoms. Sixty-eight children received immunotherapy with insect venom and 174 did not; about half were randomly assigned to treatment groups, and the rest were assigned on the basis of the patient's (or the parents') choice. The results of accidental stings during four years of observation were evaluated. Results. In the treated group, 84 stings in 36 patients resulted in one systemic reaction (1.2 percent of stings). In contrast, 196 stings in 86 untreated children resulted in 18 systemic reactions (9.2 percent of stings, P

Original languageEnglish (US)
Pages (from-to)1601-1603
Number of pages3
JournalNew England Journal of Medicine
Volume323
Issue number23
StatePublished - Dec 6 1990

Fingerprint

Insect Bites and Stings
Venoms
Bites and Stings
Immunotherapy
Hypersensitivity
Insects
Anaphylaxis
Skin Tests
Immunoglobulin E
Therapeutics
Parents
Observation
Skin
Injections
Antibodies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Valentine, M. D., Schuberth, K. C., Kagey-Sobotka, A., Graft, D. F., Kwiterovich, K. A., Szklo, M., & Lichtenstein, L. M. (1990). The value of immunotherapy with venom in children with allergy to insect stings. New England Journal of Medicine, 323(23), 1601-1603.

The value of immunotherapy with venom in children with allergy to insect stings. / Valentine, Martin D.; Schuberth, Kenneth C; Kagey-Sobotka, Anne; Graft, David F.; Kwiterovich, Kathy A.; Szklo, Moyses; Lichtenstein, Lawrence M.

In: New England Journal of Medicine, Vol. 323, No. 23, 06.12.1990, p. 1601-1603.

Research output: Contribution to journalArticle

Valentine, MD, Schuberth, KC, Kagey-Sobotka, A, Graft, DF, Kwiterovich, KA, Szklo, M & Lichtenstein, LM 1990, 'The value of immunotherapy with venom in children with allergy to insect stings', New England Journal of Medicine, vol. 323, no. 23, pp. 1601-1603.
Valentine, Martin D. ; Schuberth, Kenneth C ; Kagey-Sobotka, Anne ; Graft, David F. ; Kwiterovich, Kathy A. ; Szklo, Moyses ; Lichtenstein, Lawrence M. / The value of immunotherapy with venom in children with allergy to insect stings. In: New England Journal of Medicine. 1990 ; Vol. 323, No. 23. pp. 1601-1603.
@article{e699f41f199b44f193109ce48aaa6918,
title = "The value of immunotherapy with venom in children with allergy to insect stings",
abstract = "Background. The treatment of patients allergic to insect stings with insect-venom injections has been shown to be 97 percent effective in reducing the risk of sting-induced anaphylaxis. However, the frequency of systemic reactions to subsequent stings in unimmunized adults with previous reactions is approximately 60 percent. To determine which factors, in addition to a history of reaction and evidence of venom-specific IgE antibody, predispose patients to future insect-sting reactions, we studied a venom-sensitive group of children who were deemed to be at relatively low risk for severe reactions; 28 percent of them received venom therapy. Methods. We studied 242 children, 2 through 16 years of age, each of whom had had a systemic allergic reaction, affecting only the skin, to an insect sting. Each child had a positive skin-test reaction to one or more of five hymenopteran venoms. Sixty-eight children received immunotherapy with insect venom and 174 did not; about half were randomly assigned to treatment groups, and the rest were assigned on the basis of the patient's (or the parents') choice. The results of accidental stings during four years of observation were evaluated. Results. In the treated group, 84 stings in 36 patients resulted in one systemic reaction (1.2 percent of stings). In contrast, 196 stings in 86 untreated children resulted in 18 systemic reactions (9.2 percent of stings, P",
author = "Valentine, {Martin D.} and Schuberth, {Kenneth C} and Anne Kagey-Sobotka and Graft, {David F.} and Kwiterovich, {Kathy A.} and Moyses Szklo and Lichtenstein, {Lawrence M.}",
year = "1990",
month = "12",
day = "6",
language = "English (US)",
volume = "323",
pages = "1601--1603",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "23",

}

TY - JOUR

T1 - The value of immunotherapy with venom in children with allergy to insect stings

AU - Valentine, Martin D.

AU - Schuberth, Kenneth C

AU - Kagey-Sobotka, Anne

AU - Graft, David F.

AU - Kwiterovich, Kathy A.

AU - Szklo, Moyses

AU - Lichtenstein, Lawrence M.

PY - 1990/12/6

Y1 - 1990/12/6

N2 - Background. The treatment of patients allergic to insect stings with insect-venom injections has been shown to be 97 percent effective in reducing the risk of sting-induced anaphylaxis. However, the frequency of systemic reactions to subsequent stings in unimmunized adults with previous reactions is approximately 60 percent. To determine which factors, in addition to a history of reaction and evidence of venom-specific IgE antibody, predispose patients to future insect-sting reactions, we studied a venom-sensitive group of children who were deemed to be at relatively low risk for severe reactions; 28 percent of them received venom therapy. Methods. We studied 242 children, 2 through 16 years of age, each of whom had had a systemic allergic reaction, affecting only the skin, to an insect sting. Each child had a positive skin-test reaction to one or more of five hymenopteran venoms. Sixty-eight children received immunotherapy with insect venom and 174 did not; about half were randomly assigned to treatment groups, and the rest were assigned on the basis of the patient's (or the parents') choice. The results of accidental stings during four years of observation were evaluated. Results. In the treated group, 84 stings in 36 patients resulted in one systemic reaction (1.2 percent of stings). In contrast, 196 stings in 86 untreated children resulted in 18 systemic reactions (9.2 percent of stings, P

AB - Background. The treatment of patients allergic to insect stings with insect-venom injections has been shown to be 97 percent effective in reducing the risk of sting-induced anaphylaxis. However, the frequency of systemic reactions to subsequent stings in unimmunized adults with previous reactions is approximately 60 percent. To determine which factors, in addition to a history of reaction and evidence of venom-specific IgE antibody, predispose patients to future insect-sting reactions, we studied a venom-sensitive group of children who were deemed to be at relatively low risk for severe reactions; 28 percent of them received venom therapy. Methods. We studied 242 children, 2 through 16 years of age, each of whom had had a systemic allergic reaction, affecting only the skin, to an insect sting. Each child had a positive skin-test reaction to one or more of five hymenopteran venoms. Sixty-eight children received immunotherapy with insect venom and 174 did not; about half were randomly assigned to treatment groups, and the rest were assigned on the basis of the patient's (or the parents') choice. The results of accidental stings during four years of observation were evaluated. Results. In the treated group, 84 stings in 36 patients resulted in one systemic reaction (1.2 percent of stings). In contrast, 196 stings in 86 untreated children resulted in 18 systemic reactions (9.2 percent of stings, P

UR - http://www.scopus.com/inward/record.url?scp=0025221140&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025221140&partnerID=8YFLogxK

M3 - Article

C2 - 2098016

AN - SCOPUS:0025221140

VL - 323

SP - 1601

EP - 1603

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 23

ER -