Skip to main content

Insect Allergy: Unanswered Questions, a Postscript

  • Chapter
  • First Online:
Stinging Insect Allergy

Abstract

There are few conditions that are as treatable as Hymenoptera venom allergy. It also is a window into other conditions such as mast cell disease and anaphylaxis. Over the years, much work has been accomplished to help our patients and better understand this potentially lethal but highly treatable condition. Our understanding of risk factors, improved diagnostic modalities, and potential comorbid conditions have been instrumental in constructing an exceptional, data-driven approach to Hymenoptera venom allergy. Unfortunately, to answer a question there is not always perfect data, and periodically, there is no way to ethically obtain it. In most of those cases, there is often consensus. However, in the end, there will always be unanswered questions. These are a few of those unanswered questions.

“My entire life consisted of musings, calculations, practical works, and trials. Many questions remain unanswered; many works are incomplete or unpublished. The most important things still lie ahead.” Konstantin Tsiolkovsky

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

VIT:

Venom immunotherapy

BAT:

Basophil activation test

ST:

Skin test

HVA:

Hymenoptera venom allergy

References

  1. Tracy JM, Demain JG, Quinn JM, et al. The natural history of exposure to the imported fire ant. J Allergy Clin Immunol. 1995;95:824–8.

    Article  CAS  PubMed  Google Scholar 

  2. Golden DB, Demain J, Freeman T, et al. Stinging insect hypersensitivity: a practice parameter update 2016. Ann Allergy Asthma Immunol. 2017;118(1):28–54.

    Article  PubMed  Google Scholar 

  3. Cohen SG, Bianchine PJ. Hymenoptera, hypersensitivity, and history: a prologue to current day concepts and practices in the diagnosis, treatment, and prevention of insect sting allergy. Ann Allergy Asthma Immunol. 1995;74:198–217.

    CAS  PubMed  Google Scholar 

  4. Bonadonna P, Perbellini O, Passalacqua G, et al. Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels. J Allergy Clin Immunol. 2009;123:680–6.

    Article  CAS  PubMed  Google Scholar 

  5. Castells MC, Hornick JL, Akin C. Anaphylaxis after hymenoptera sting: is it venom allergy, a clonal disorder, or both? J Allergy Clin Immunol Pract. 2015;3:350–5.

    Article  PubMed  Google Scholar 

  6. Kontou-Fill K, Fillis CI, Voulgari C, Panayiotidis PG. Omalizumab monotherapy for bee sting and unprovoked ’anaphylaxis’ in a patient with systemic mastocytosis and undetectable specific IgE. Ann Allergy Asthma Immunol. 2010;104:537–9.

    Article  Google Scholar 

  7. Douglass JA, Carroll K, Voskamp A, et al. Omalizumab is effective in treating systemic mastocytosis in a nonatopic patient. Allergy. 2009;65:926–7.

    Article  PubMed  Google Scholar 

  8. Tracy JM, Olsen JA, Carlson J. A “difficult” insect allergy patient: reliable history of a sting, but all testing negative. Curr Opin Allergy Clin Immunol. 2012;12:400–5.

    Article  PubMed  Google Scholar 

  9. Golden DB, Moffitt J, Nicklas RA, Joint Task Force on Practice Parameters, American Academy of Allergy, Asthma & Immunology (AAAAI), American College of Allergy, Asthma & Immunology (ACAAI), Joint Council of Allergy, Asthma and Immunology. Stinging insect hypersensitivity: a practice parameter update. J Allergy Clin Immunol. 2011;127:852–4.

    Article  PubMed  Google Scholar 

  10. Bilo MB, Severino M, Cilia M, et al. The VISYT trial: venom immunotherapy safety and tolerability with purified vs nonpurified extracts. Ann Allergy Asthma Immunol. 2009;103:57–61.

    Article  PubMed  Google Scholar 

  11. Golden DBK, Kelly D, Hamilton RG, et al. Dialyzed venom skin tests for identifying yellow jacket-allergic patients not detected using standard venom. Ann Allergy Asthma Immunol. 2009;102:47–50.

    Article  PubMed  Google Scholar 

  12. Eberlein B, Hann R, Eyerich S, Pennino D, Ring J, Schmidt-Weber CB, et al. Optimizing of the basophil activation test: comparison of different basophil identification markers. Cytometry B Clin Cytom. 2015;88:183–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James M. Tracy D.O., F.A.C.A.A.I., F.A.A.A.A.I. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Tracy, J.M. (2017). Insect Allergy: Unanswered Questions, a Postscript. In: Freeman, T., Tracy, J. (eds) Stinging Insect Allergy. Springer, Cham. https://doi.org/10.1007/978-3-319-46192-2_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-46192-2_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46190-8

  • Online ISBN: 978-3-319-46192-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics