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Successful treatment of occupational allergy to bumblebee venom after failure with honeybee venom extract
Author(s) -
Stern A.,
Müllner G.,
Wüthrich B.
Publication year - 2000
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1034/j.1398-9995.2000.00202.x
Subject(s) - venom , allergy , medicine , sting , immunology , bumblebee , immunoglobulin e , anaphylaxis , antibody , biology , pollen , ecology , pollinator , pollination , engineering , aerospace engineering
Background : Immediate‐type allergies to bumblebee stings occur infrequently. Previous studies have demonstrated a high degree of cross‐reactivity between honeybee venom (HBV) and bumblebee venom (BBV). It has been proposed that venom immunotherapy (VIT) with HBV is a therapeutic alternative for patients with BBV allergy. Methods and results : We present two cases of occupational immediate‐type allergies to BBV. Although both nonatopic patients had a negative personal history of previous allergic reactions to honeybee sting, specific IgE antibodies and a positive intradermal reaction to HBV were detected. Despite VIT with HBV, the two developed another severe allergic reaction after incidental bumblebee stings. VIT with BBV, using in one patient a rush protocol with escalating doses of 0.01–100 μg of BBV, was performed. Before and during the VIT, the course of IgE and IgG specific antibodies to BBV was analyzed, demonstrating a significant decrease of BBV‐IgE and an increase of BBV‐IgG. The effectiveness of the treatment was also proven by an in‐hospital sting challenge with a live bumblebee. Conclusions : Our data demonstrate that cross‐immunotherapies with HBV do not protect BBV‐allergic patients sufficiently. We conclude that BBV‐allergic patients should be treated with BBV. A “rush” VIT with BBV is a safe alternative to a “conventional” protocol.