Stinging insect XXXX : natural history and modification with venom immunotherapy.

@entity1 @entity566 @entity4 @entity5157 @entity2021
The natural history of stinging insect @entity566 and its modification by venom immunotherapy was investigated by follow-up observations of @entity1 with histories of venom anaphylaxis and detectable venom-specific IgE. The @entity1 were divided into three categories: (1) receiving venom immunotherapy, (2) declined venom immunotherapy, and (3) terminated venom immunotherapy. One hundred twenty-seven @entity1 were evaluated after 6 mo to 9 yr of venom immunotherapy. Most received top venom doses of 50 micrograms of yellow jacket and/or @entity5157 venoms every 4 wk. There were 87 restings in 48 @entity1 resulting in two systemic reactions, only one of which could be considered a treatment failure (1%). Fifty-six @entity1 never received venom immunotherapy. In this group there were 40 restings in 28 @entity1 with 14 systemic reactions (35%). In 88 @entity1 who stopped venom immunotherapy, 61 restings in 41 @entity1 led to 11 systemic reactions (17%). @entity1 with cardiovascular/or respiratory symptoms with @entity2021 were at risk for subsequent reactions. With one exception, @entity1 with hives and @entity4 only as the initial reaction either had a similar or no reaction when they were restung. These results confirm the efficacy of venom immunotherapy but also suggest that there are factors other than the presence of venom-specific IgE modulating the occurrence of clinical anaphylaxis.
