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    Safety and efficacy of venom immunotherapy: a real life study.
    Postepy Dermatol Alergol 2017 Apr 13;34(2):159-167. Epub 2017 Apr 13.
    Clinical Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland.
    Introduction: Venom immunotherapy (VIT) is recommended as the first-line treatment for patients allergic to Hymenoptera venom.

    Aim: To analyze the safety and efficacy of VIT in a real life setting.

    Material And Methods: One hundred and eighty patients undergoing VIT were studied to evaluate the safety, efficacy, incidence and nature of symptoms after field stings and adverse reactions to VIT. Read More

    Fatal Anaphylaxis to Yellow Jacket Stings in Mastocytosis: Options for Identification and Treatment of At-Risk Patients.
    J Allergy Clin Immunol Pract 2017 May 10. Epub 2017 May 10.
    Department of Allergology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    Background: Patients with indolent systemic mastocytosis (ISM) are at risk for severe anaphylactic reactions to yellow jacket (YJ) stings while demonstration of sensitization can be challenging because specific IgE (sIgE) levels are regularly below 0.35 kUA/L. The implication of missing YJ allergy is illustrated by a case of fatal anaphylaxis. Read More

    Arthropod Envenomation in North America.
    Emerg Med Clin North Am 2017 May;35(2):355-375
    Section of Emergency Medicine, University of Chicago, Chicago, IL, USA.
    Arthropods (phylum Arthopoda) account for a higher percentage of morbidity and mortality to humans than do mammalian bites, snake bites, or marine envenomation. They are ubiquitous in domestic dwellings, caves, and campsites and in wilderness settings such as deserts, forests, and lakes. Although arthropods are most intrusive during warmer months, many are active throughout the winter, particularly indoors. Read More

    Long-Term Follow-Up of Children after Venom Immunotherapy: Low Adherence to Anaphylaxis Guidelines.
    Int Arch Allergy Immunol 2017 6;172(3):167-172. Epub 2017 Apr 6.
    Division of Pediatric Pneumology and Allergy, University Hospital for Children and Adolescents, Leipzig, Germany.
    Background: Data on the long-term outcome of children after specific venom immunotherapy (VIT) are limited. Therefore, we assessed sting recurrence and anaphylaxis relapse rates as well as adherence to anaphylaxis guidelines with regard to the availability of emergency equipment and education status.

    Methods: For this long-term survey, data of 311 children with a history of anaphylactic reactions to hymenoptera stings were collected by chart review. Read More

    Decontamination Work and the Long-term Increase in Hospital Visits for Hymenoptera Stings Following the Fukushima Nuclear Disaster.
    Disaster Med Public Health Prep 2017 Mar 8:1-7. Epub 2017 Mar 8.
    1Department of Surgery,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
    Objective: Animals, including arthropods, are one health threat that can be affected by disasters. This institution-based study aimed to assess trends in Hymenoptera stings following the 2011 Fukushima nuclear disaster.

    Methods: We reviewed the medical records of patients with hymenopteran stings who visited Minamisoma Municipal General Hospital, located 23 km from Fukushima Daiichi Nuclear Power Plant, from March 2005 to March 2016. Read More

    Public Medical Preparedness at the "Swiss Wrestling and Alpine Games 2013": Descriptive Analysis of 1,533 Patients Treated at the Largest 3-Day Sporting Event in Switzerland.
    Emerg Med Int 2017 6;2017:9162095. Epub 2017 Feb 6.
    Department for Visceral Surgery and Medicine, Division of Acute Care Surgery, Bern University Hospital, Bern, Switzerland.
    Introduction. Medical preparedness at mass gatherings is challenging, as little is known about the optimal planning. Most studies and case reports are based on mass casualty incidents, so the results cannot be extrapolated to mass gatherings. Read More

    American Academy of Asthma, Allergy & Immunology membership experience with venom immunotherapy in chronic medical conditions and pregnancy, and in young children.
    Allergy Asthma Proc 2017 Mar;38(2):121-129
    Background: Few data exist regarding the use of venom immunotherapy (VIT) in specific high-risk chronic medical conditions and pregnancy, and in young children.

    Methods: A Web-based survey was sent to American Academy of Asthma Allergy & Immunology members to explore their VIT experience in potential high-risk medical conditions and pregnancy, and in young children. Major problems were defined as "activation of underlying disease and/or VIT not well tolerated (systemic adverse events) and/or VIT discontinued for medical reasons. Read More

    Longitudinal Study of Pediatric Urticaria Pigmentosa.
    Pediatr Dermatol 2017 Mar 30;34(2):144-149. Epub 2017 Jan 30.
    Department of Dermatology, Mayo Clinic Health System, Eau Claire, Wisconsin.
    Background/objectives: Urticaria pigmentosa (UP) is the most common form of mastocytosis in children and is associated with systemic signs, symptoms, and triggers. To our knowledge, the effect of UP on children's quality of life has not been studied. The objective of the current study was to characterize the natural history, triggers, and complications of pediatric UP, identify prognostic indicators, and determine its effect on quality of life. Read More

    Hymenoptera Venom Allergy. A closer collaboration is needed between allergists and emergency physicians.
    Eur Ann Allergy Clin Immunol 2017 Jan;49(1):15-17
    Allergy Unit, Loreto Crispi Hospital, ASL Napoli 1 - Centro, Naples, Italy. E-mail:
    Background. Hymenoptera stings are sometimes fatal in venom-allergic patients. Fatalities mostly occur in previously stung subjects, especially those with a history of systemic reactions, and could be avoided if patients were properly informed of the existence of a prevention strategy for insect stings, referred to an allergy follow-up and prescribed auto-injectable epinephrine and/or venom-specific immunotherapy (VIT). Read More

    Pre-hospital treatment of bee and wasp induced anaphylactic reactions: a retrospective study.
    Scand J Trauma Resusc Emerg Med 2017 Jan 14;25(1). Epub 2017 Jan 14.
    Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Sdr. Boulevard 29, Odense, DK-5000, Denmark.
    Background: Bee and wasp stings are among the most common triggers of anaphylaxis in adults representing around 20% of fatal anaphylaxis from any cause. Data of pre-hospital treatment of bee and wasp induced anaphylactic reactions are sparse. This study aimed to estimate the incidence of bee and wasp induced anaphylactic reactions, the severity of the reactions and to correlate the pre-hospital treatment with the severity of the anaphylactic reaction. Read More

    [Mastocytosis : Clinical aspects, diagnostics, therapy].
    Hautarzt 2017 Jan;68(1):67-75
    Mastozytosezentrum der Klinik für Dermatologie, Venerologie, Allergologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.
    Mastocytosis is a rare, almost exclusively sporadically occurring disease involving an increase in clonal tissue mast cells. The disease spectrum is heterogenous, ranging from isolated skin lesions with a normal life expectancy to rare, aggressive forms with very poor prognosis. Children are often affected. Read More

    Hymenoptera venom allergy in outdoor workers: Occupational exposure, clinical features and effects of allergen immunotherapy.
    Hum Vaccin Immunother 2017 Feb;13(2):477-483
    a Department of Health Sciences , Postgraduate School in Occupational Medicine and Occupational Medicine Unit, IRCCS AOU San Martino-IST, University of Genoa , Genoa , Italy.
    Objectives: To describe (i) the clinical characteristics of workers, exposed to hymenoptera stings, with an ascertained diagnosis of Hymenoptera Venom Allergy (HVA), (ii) the specific role of occupational exposure, (iii) the effect of Venom Immunotherapy (VIT) in reducing the severity of allergic episodes in workers exposed to repeated stings of hymenoptera, and (iv) the management of the occupational consequences caused by allergic reactions due to hymenoptera stings.

    Methods: Between 2000 and 2013 an observational study, including patients referred to the regional reference hospital of Liguria, Italy, with an ascertained diagnosis of HVA and treated with VIT, was performed. A structured questionnaire was administered to all patients to investigate the occupational features of allergic reactions. Read More

    Mastocytosis and Anaphylaxis.
    Immunol Allergy Clin North Am 2017 Feb 28;37(1):153-164. Epub 2016 Oct 28.
    Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany. Electronic address:
    This article updates current knowledge on epidemiology, risk factors, triggers, and management of anaphylaxis in patients with mastocytosis. Hyperactive mast cells and higher number of effector mast cells are speculated to facilitate anaphylaxis in this condition. In children, increased risk is limited to those with extensive skin involvement and high tryptase. Read More

    Possible complication of bee stings and a review of the cardiac effects of bee stings.
    BMJ Case Rep 2016 Nov 1;2016. Epub 2016 Nov 1.
    Department of Cardiology, Medical College Hospital, Trivandrum, Trivandrum, Kerala, India.
    We report the case of a patient who, ∼3 weeks after multiple bee stings, developed a prolonged heart block, syncope and cardiac arrest. This required a temporary pacemaker to be implanted, which was later replaced with a permanent pacemaker. An ECG taken following surgery for a fractured humerus 6 years earlier was reportedly normal. Read More

    Fatal anaphylaxis from hymenoptera stings.
    Med Leg J 2016 Dec 26;84(4):212-214. Epub 2016 Jul 26.
    Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India.
    Venomous insect stings are a cause of morbidity and mortality worldwide. The sting reactions are unpredictable and vary among individuals. A case of fatal insect sting in an elderly female is presented to discuss the associated challenges during necropsy. Read More

    Stinging the Conscience: A Case of Severe Hymenoptera Anaphylaxis and the Need for Provider Awareness.
    Mil Med 2016 Oct;181(10):e1400-e1403
    Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda MD 20889.
    Hymenoptera venom allergy accounts for approximately 17% of all cases of anaphylaxis. Insect stings are a common occurrence across the world, with significant impact on active duty personnel. Venom immunotherapy (VIT) provides an effective treatment for those with systemic reactions to insect stings and other similar indications. Read More

    [Mortal poisoning by bee stings in a child: Study of a case observed in the regional hospital of Maradi (Niger)].
    Bull Soc Pathol Exot 2016 Dec 13;109(5):325-328. Epub 2016 Oct 13.
    Service de pédiatrie, hôpital national de Lamordé, université Abdou-Moumouni-Dioffo, Niamey, Niger.
    We report a fatal case due to a massive attack by a swarm of bees in a nine-year-old child. The accident was fatal because of two aggravating factors: the cephalic location and the large number of stings (about 300). Complications were coagulopathy, anemia, hemorrhage, coma, and oligoanuria. Read More

    Honey Bee Swarms Aboard the USNS Comfort: Recommendations for Sting Prevention, Swarm Removal, and Medical Readiness on Military Ships.
    US Army Med Dep J 2016 Oct-Dec(3-16):29-37
    Navy and Marine Corps Public Health Center, Portsmouth, Virginia.
    The article provides observations of multiple honey bee (Apis mellifera) swarms aboard the USNS Comfort (TAH-20) during the Continuing Promise 2015 mission. A brief overview of swarming biology is given along with control/removal recommendations to reduce sting exposures. The observations suggest that preventive medicine personnel should provide adequate risk communications about the potential occurrence of bee swarms aboard military ships, and medical department personnel should be prepared for the possibility of treating of multiple sting exposures, especially in the Southern Command Area of Operations where the Africanized genotype of A mellifera is common. Read More

    Specific IgE sensitization to honey bee venom and auto-injector adrenaline prescriptions for Japanese beekeepers.
    Allergol Int 2017 Jan 8;66(1):149-151. Epub 2016 Aug 8.
    Department of Respiratory Medicine and Clinical Immunology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.

    [Not Available].
    Lakartidningen 2016 Aug 4;113. Epub 2016 Aug 4.
    Futurum - Akademin för hälsa och vård - Länssjukhuset Ryhov Jönköping, Sweden Futurum - Akademin för hälsa och vård - Länssjukhuset Ryhov Jönköping, Sweden.
    Bee and wasp stings can cause allergic reactions. Although the local reactions are more frequent, anaphylaxis due to insect stings can be potentially fatal. Rapid recognition of anaphylaxis is therefore critical and reactions should immediately be treated with i. Read More

    Application of recombinant antigen 5 allergens from seven allergy-relevant Hymenoptera species in diagnostics.
    Allergy 2017 Jan 26;72(1):98-108. Epub 2016 Aug 26.
    Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany.
    Background: Hymenoptera stings can cause severe anaphylaxis in untreated venom-allergic patients. A correct diagnosis regarding the relevant species for immunotherapy is often hampered by clinically irrelevant cross-reactivity. In vespid venom allergy, cross-reactivity between venoms of different species can be a diagnostic challenge. Read More

    Evaluation of Anaphylaxis Management in a Pediatric Emergency Department.
    Pediatr Emerg Care 2016 Aug;32(8):508-13
    From the Departments of *Pediatrics Emergency Medicine †Pediatric Allergy and Immunology, and ‡Biostatistics, University of Arkansas for Medical Sciences and Arkansas Children Hospital, Little Rock, AR.
    Objective: In 2006, the National Institute of Allergy and Infectious Disease established evidence-based treatment guidelines for anaphylaxis. The purpose of our study was to evaluate provider adherence to guidelines-based management for anaphylaxis in a tertiary care pediatric emergency department (ED).

    Methods: Retrospective chart review was conducted of patients (0-18 years) presenting to the Arkansas Children Hospital ED from 2004 to 2011 for the treatment of anaphylaxis using International Classification of Diseases, Ninth Edition, codes. Read More

    Changes in the Expression of MicroRNA in the Buildup Phase of Wasp Venom Immunotherapy: A Pilot Study.
    Int Arch Allergy Immunol 2016 22;170(2):97-100. Epub 2016 Jul 22.
    Department of Allergology, Medical University of Gdansk, Gdansk, Poland.
    Background: Allergen-specific immunotherapy is the most effective method of treatment in allergy to wasp venom. However, its mechanism of action is still not fully understood. The aim of this study is to describe changes in microRNA (miRNA) expression in patients undergoing the buildup phase of venom immunotherapy. Read More

    Hymenoptera stings in the head region induce impressive, but not severe sting reactions.
    Allergy 2016 Nov 15;71(11):1632-1634. Epub 2016 Jul 15.
    Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria.
    Stings in the head region are considered to be a risk factor for severe systemic reactions to hymenoptera stings. We supposed that stings in skin areas, which are well supplied with blood, lead to more severe reactions and tested our hypothesis in 847 patients with confirmed hymenoptera venom allergy. However, symptom severity was independent from sting site: only 16. Read More

    Short-, Intermediate-, and Long-Term Changes in Basophil Reactivity Induced by Venom Immunotherapy.
    Allergy Asthma Immunol Res 2016 Sep;8(5):412-20
    San Pedro de Alcántara Hospital, Immunology Department, Cáceres Spain.
    Purpose: The basophil activation test (BAT) has been used to monitor venom immunotherapy (VIT) due to its high specificity. A previous study has reported a good correlation between a significant decrease in basophil activation during 5 years of VIT and clinical protection assessed by sting challenge. The following prospective study was performed to examine changes in basophil reactivity over a complete VIT period of 5 years. Read More

    EPIDEMIOLOGY OF HONEYBEE STING CASES IN THE STATE OF CEARÁ, NORTHEASTERN BRAZIL.
    Rev Inst Med Trop Sao Paulo 2016 24;58:40. Epub 2016 May 24.
    Centro de Educação e Saúde, Universidade Federal de Campina Grande, Paraíba, Brasil.
    In the American continent, honeybee envenomation is a public health problem due to the high incidence and severity of the cases. Despite its medical importance, there is a lack of epidemiological studies on this topic in Brazil, especially referring to the Northeastern states. The present study has aimed to describe the epidemiological features of honeybee envenomation cases in the state of the Ceará, Northeastern Brazil, from 2007 to 2013. Read More

    Identifying and managing Hymenoptera venom allergy.
    Nurs Stand 2016 May;30(39):44-51
    St Thomas' Hospital, Guys and St Thomas' NHS Foundation Trust, London, England.
    Hymenoptera venom allergy is an immunoglobulin E (IgE)-mediated hypersensitivity to the venom of insects from the Hymenoptera order and is a common cause of anaphylaxis. A diagnosis of venom allergy is made by taking an accurate medical, family and social history, alongside specific allergy testing. Systemic reactions to Hymenoptera venom occur in a small proportion of the population; these range from mild to life-threatening in severity. Read More

    Efficacy of Two Combinations of Blood Purification Techniques for the Treatment of Multiple Organ Failure Induced by Wasp Stings.
    Blood Purif 2016 13;42(1):49-55. Epub 2016 Apr 13.
    Department of Nephrology, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, Hubei, China.
    Background/aims: The aim of this study was to explore the clinical efficacy of 2 combinations of blood purification techniques in patients with sting venom-induced multiple organ dysfunction syndrome (MODS).

    Methods: A total of 23 patients received 35 sessions of hemoperfusion (HP) + continuous veno-venous hemodiafiltration (CVVHDF) treatment and 22 sessions of plasma exchange (PE) + CVVHDF treatment, respectively.

    Results: Both HP + CVVHDF and PE + CVVHDF reduced the levels of inflammation, thus improving our patients' health condition. Read More

    Self-medication of anaphylactic reactions due to Hymenoptera stings-an EAACI Task Force Consensus Statement.
    Allergy 2016 Jul 29;71(7):931-43. Epub 2016 Apr 29.
    Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
    An anaphylactic reaction due to a Hymenoptera sting is a clinical emergency, and patients, their caregivers as well as all healthcare professionals should be familiar with its recognition and acute management. This consensus report has been prepared by a European expert panel of the EAACI Interest Group of Insect Venom Hypersensitivity. It is targeted at allergists, clinical immunologists, internal medicine specialists, pediatricians, general practitioners, emergency department doctors, and any other healthcare professional involved. Read More

    The Basophil Activation Test Is Not a Useful Screening Tool for Hymenoptera Venom-Related Anaphylaxis in Patients with Systemic Mastocytosis.
    Int Arch Allergy Immunol 2016 8;169(2):125-9. Epub 2016 Apr 8.
    Section of Clinical Immunology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
    Background: Systemic mastocytosis (SM) patients are at a high risk for anaphylaxis, with Hymenoptera as the main culprit. A screening instrument to identify which patients are sensitized to Hymenoptera before they experience anaphylaxis would therefore be of great value. The basophil activation test (BAT) is proposed as a possible tool for diagnosing Hymenoptera venom-related allergy (HVA), especially in patients in whom conventional allergy tests yield contradictory results. Read More

    Myocardial infarction following a bee sting: A case report of Kounis syndrome.
    Ann Card Anaesth 2016 Apr-Jun;19(2):375-8
    Department of Emergency Medicine, School of Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
    In this case report study a 41-year-old man envenomed by a bee sting and diagnosed as Kounis syndrome secondary to hymenoptera envenomation. The patient developed a typical course of myocardial infarction, but the electrocardiogram changes were reversed to almost normal limits. He had a nonsignificant mild lesion in the proximal port of right coronary artery in coronary angiography. Read More

    IgE Reactivity of Recombinant Pac c 3 from the Asian Needle Ant (Pachycondyla chinensis).
    Int Arch Allergy Immunol 2016 5;169(2):93-100. Epub 2016 Apr 5.
    Department of Internal Medicine, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
    Background: Stings from the Asian needle ant are an important cause of anaphylaxis in East Asia. A 23-kDa protein homologous to antigen 5 is the major allergen produced by these ants. In this study, we aimed to produce a recombinant antigen 5 allergen, Pac c 3. Read More

    Safety of Ultrarush Venom Immunotherapy: Comparison Between Children and Adults.
    J Investig Allergol Clin Immunol 2016 ;26(1):40-7
    Background: The ultrarush protocol is an attractive approach in the buildup phase of venom immunotherapy (VIT-UR). However, the degree of risk of VIT-UR in children remains unknown. The objective of this study was to compare the safety of VIT-UR in children and adults. Read More

    Natural history of Hymenoptera venom allergy in children not treated with immunotherapy.
    Ann Allergy Asthma Immunol 2016 Mar;116(3):225-9
    Icahn School of Medicine at Mount Sinai, Jaffe Food Allergy Institute, New York, New York.
    Background: Differences in treatment approach still exist for children after systemic sting reactions. In addition, there are still some doubts about when systemic reactors should be treated with venom immunotherapy (VIT).

    Objective: To determine the rate of sting recurrence and natural history of Hymenoptera venom allergy (HVA) in children not treated with VIT. Read More

    Acute interstitial nephritis, toxic hepatitis and toxic myocarditis following multiple Asian giant hornet stings in Shaanxi Province, China.
    Environ Health Prev Med 2016 Jul 24;21(4):231-6. Epub 2016 Feb 24.
    Department of Medical Education, 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong, 723000, Shaanxi, China.
    Objectives: During July to October 2013, the Asian giant hornet has killed 42 and injured 1,675 people in the southern part of Shaanxi Province, China. This study investigated this unusual and frequent public health event.

    Methods: During the 3 months, 103 patients with severe Asian hornet stings were hospitalized in our hospital. Read More

    Climate data, localisation of the sting, grade of anaphylaxis and therapy of hymenoptera stings.
    Swiss Med Wkly 2016 9;146:w14272. Epub 2016 Feb 9.
    University Clinic for Rheumatology, Immunology and Allergology, Insel Hospital, University Hospital Bern, Switzerland.
    International epidemiological studies indicate that around 1-7% of the population respond with an allergic reaction to a hymenoptera sting, which is frequently associated with admission to an emergency department. This retrospective study included patients admitted between 2009 and 2013 to an emergency department after a hymenoptera sting. In all, 86 (60. Read More

    Comparing the ability of molecular diagnosis and CAP-inhibition in identifying the really causative venom in patients with positive tests to Vespula and Polistes species.
    Clin Mol Allergy 2016 8;14. Epub 2016 Feb 8.
    Allergy/Pulmonary Rehabilitation, ICP Hospital, Via Bignami 1, 20100 Milan, Italy.
    Background: Cross-reactivity among Hymenoptera venoms is an important issue when prescribing venom immunotherapy (VIT). Using all venoms eliciting a positive response results in treatment excess and unjustified cost increase. The first in vitro method that helped to identify the really causative venom was RAST-inhibition, but in latest years also molecular allergy (MA) diagnostics, that detects specific sIgE to single venom allergens, was introduced. Read More

    Pathophysiological effects caused by the venom of the social wasp Synoeca surinama.
    Toxicon 2016 Apr 5;113:41-8. Epub 2016 Feb 5.
    Laboratory of Toxinology, Department of Physiological Sciences, Institute of Biological Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF, Brazil. Electronic address:
    Envenomation by wasp stings is a public health preoccupation, and signals after stings have variable effects depending on the number of attacks and individual sensitivities. Even with the high rate of wasp sting cases, the study of phatophysiological effects of the envenomation is still very incipient. In this context, early and accurate assessment of this prognostic can aid in the reduction of the symptomatology and complete remission of the later symptoms. Read More

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