| Mastocytosis and insect venom allergy. | |
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MedLine Citation:
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PMID: 20485157 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: To analyse the association of systemic allergic hymenoptera sting reactions with mastocytosis and elevated baseline serum tryptase and to discuss diagnosis and treatment in patients with both diseases. RECENT FINDINGS: In recent large studies on patients with mastocytosis a much higher incidence of severe anaphylaxis following hymenoptera stings than in the normal population was documented. In patients with hymenoptera venom allergy, elevated baseline tryptase is strongly associated with severe anaphylaxis. Fatal sting reactions were reported in patients with mastocytosis, notably after stopping venom immunotherapy. During venom immunotherapy most patients with mastocytosis are protected from further sting reactions. Based on these observations immunotherapy for life is recommended for patients with mastocytosis and venom allergy. The incidence of allergic side-effects is increased in patients with mastocytosis and elevated baseline tryptase, especially in those allergic to Vespula venom. Premedication with antihistamines, or omalizumab in cases with recurrent severe side-effects, can be helpful. SUMMARY: In all patients with anaphylaxis following hymenoptera stings, baseline serum tryptase should be determined. A value above 11.4 microg/l is often due to mastocytosis and indicates a high risk of very severe anaphylaxis following re-stings. Venom immunotherapy is safe and effective in this situation. |
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Authors:
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Patrizia Bonadonna; Roberta Zanotti; Ulrich Müller |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in allergy and clinical immunology Volume: 10 ISSN: 1473-6322 ISO Abbreviation: Curr Opin Allergy Clin Immunol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-08 Completed Date: 2010-10-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100936359 Medline TA: Curr Opin Allergy Clin Immunol Country: United States |
Other Details:
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Languages: eng Pagination: 347-53 Citation Subset: IM |
Affiliation:
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Allergy Unit, Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. patrizia.bonadonna@ospedaleuniverona.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anaphylaxis
/
etiology*,
immunology,
prevention & control Animals Anti-Allergic Agents / therapeutic use Arthropod Venoms / administration & dosage, adverse effects, immunology* Desensitization, Immunologic / methods Humans Hymenoptera / immunology* Hypersensitivity, Immediate / complications*, etiology, immunology, therapy Insect Bites and Stings / immunology Mastocytosis / complications*, diagnosis, immunology, therapy Tryptases / blood* Wasp Venoms / administration & dosage, adverse effects, immunology |
| Chemical | |
Reg. No./Substance:
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0/Anti-Allergic Agents; 0/Arthropod Venoms; 0/Wasp Venoms; EC 3.4.21.59/Tryptases |
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