Hymenoptera venom allergy in children
Abstract From a taxonomic point of view, Hymenoptera are subclassified into families: Apidae, including honeybees (Apis mellifera) and bumblebees (Bombus), and Vespidae, which, in turn, are divided into the subfamilies of Vespinae (wasps, including hornets, vespules, dolichovespules) and Polistinae...
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BMC
2024-12-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-024-01731-9 |
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| author | Mattia Giovannini Francesca Mori Simona Barni Francesca Saretta Stefania Arasi Riccardo Castagnoli Lucia Liotti Carla Mastrorilli Luca Pecoraro Lucia Caminiti Gunter Johannes Sturm Gian Luigi Marseglia Michele Miraglia del Giudice Elio Novembre |
| author_facet | Mattia Giovannini Francesca Mori Simona Barni Francesca Saretta Stefania Arasi Riccardo Castagnoli Lucia Liotti Carla Mastrorilli Luca Pecoraro Lucia Caminiti Gunter Johannes Sturm Gian Luigi Marseglia Michele Miraglia del Giudice Elio Novembre |
| author_sort | Mattia Giovannini |
| collection | DOAJ |
| description | Abstract From a taxonomic point of view, Hymenoptera are subclassified into families: Apidae, including honeybees (Apis mellifera) and bumblebees (Bombus), and Vespidae, which, in turn, are divided into the subfamilies of Vespinae (wasps, including hornets, vespules, dolichovespules) and Polistinae (paper wasp). Hypersensitivity to Hymenoptera venom can be linked to immunological (IgE-mediated or non-IgE-mediated) and non-immunological mechanisms. Reactions are classified into local reactions, large local reactions, systemic reactions, toxic reactions, and unusual reactions. In general, children sensitize less frequently and have less severe reactions than adults, probably due to less exposure to repeated stings and fewer comorbidities. There are risk factors for systemic reactions that should be discussed with patients and their parents as appropriate. A correct diagnosis of Hymenoptera venom allergy relies on a careful clinical history and the appropriate use of skin and in vitro tests. The in vitro tests include serum specific IgE toward venom extracts and toward allergenic molecules. In complex diagnoses, CAP-inhibition and the Basophil Activation Test can also be used. In the presence of a systemic reaction, the basal serum tryptase measurement should be performed to rule out mastocytosis. In case of allergic reactions to Hymenoptera stings, in the acute phase, according to the current guidelines, the treatment of signs and symptoms mainly includes the use of adrenaline as first-line treatment in case of anaphylaxis and antihistamines and corticosteroids as subsequent lines of treatment. Given the impossibility of avoiding a new sting with certainty, the treatment of choice in subjects with hypersensitivity to Hymenoptera venom who have experienced systemic reactions is based on venom immunotherapy (VIT), with the venom of the responsible stinging insect identified after an adequate allergological work-up. VIT is performed in a suitable environment and has proved to be safe and effective with various administration protocols, both accelerated and conventional. The prevention of Hymenoptera venom anaphylaxis in patients who have already developed a previous episode is crucial and must be supported by environmental protection interventions and early therapy. Places where one is more likely to encounter insects and risky behaviors should be avoided. |
| format | Article |
| id | doaj-art-fbca8a4cbae94c8990d64f8d6e06022c |
| institution | Kabale University |
| issn | 1824-7288 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj-art-fbca8a4cbae94c8990d64f8d6e06022c2024-12-22T12:38:20ZengBMCItalian Journal of Pediatrics1824-72882024-12-0150111410.1186/s13052-024-01731-9Hymenoptera venom allergy in childrenMattia Giovannini0Francesca Mori1Simona Barni2Francesca Saretta3Stefania Arasi4Riccardo Castagnoli5Lucia Liotti6Carla Mastrorilli7Luca Pecoraro8Lucia Caminiti9Gunter Johannes Sturm10Gian Luigi Marseglia11Michele Miraglia del Giudice12Elio Novembre13Allergy Unit, Meyer Children’s Hospital IRCCSAllergy Unit, Meyer Children’s Hospital IRCCSAllergy Unit, Meyer Children’s Hospital IRCCSPediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli CentraleAllergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children’s Hospital IRCCSDepartment of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of PaviaPediatric Unit, Department of Mother and Child Health, Salesi Children’s HospitalPediatric Hospital Giovanni XXIII, Pediatric and Emergency Department, AOU Policlinic of BariPediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of VeronaDepartment of Human Pathology in Adult and Development Age “Gaetano Barresi”, Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano MartinoDepartment of Dermatology and Venerology, Medical University of GrazDepartment of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of PaviaDepartment of Woman, Child and General and Specialized Surgery, University of Campania Luigi VanvitelliDepartment of Health Sciences, University of FlorenceAbstract From a taxonomic point of view, Hymenoptera are subclassified into families: Apidae, including honeybees (Apis mellifera) and bumblebees (Bombus), and Vespidae, which, in turn, are divided into the subfamilies of Vespinae (wasps, including hornets, vespules, dolichovespules) and Polistinae (paper wasp). Hypersensitivity to Hymenoptera venom can be linked to immunological (IgE-mediated or non-IgE-mediated) and non-immunological mechanisms. Reactions are classified into local reactions, large local reactions, systemic reactions, toxic reactions, and unusual reactions. In general, children sensitize less frequently and have less severe reactions than adults, probably due to less exposure to repeated stings and fewer comorbidities. There are risk factors for systemic reactions that should be discussed with patients and their parents as appropriate. A correct diagnosis of Hymenoptera venom allergy relies on a careful clinical history and the appropriate use of skin and in vitro tests. The in vitro tests include serum specific IgE toward venom extracts and toward allergenic molecules. In complex diagnoses, CAP-inhibition and the Basophil Activation Test can also be used. In the presence of a systemic reaction, the basal serum tryptase measurement should be performed to rule out mastocytosis. In case of allergic reactions to Hymenoptera stings, in the acute phase, according to the current guidelines, the treatment of signs and symptoms mainly includes the use of adrenaline as first-line treatment in case of anaphylaxis and antihistamines and corticosteroids as subsequent lines of treatment. Given the impossibility of avoiding a new sting with certainty, the treatment of choice in subjects with hypersensitivity to Hymenoptera venom who have experienced systemic reactions is based on venom immunotherapy (VIT), with the venom of the responsible stinging insect identified after an adequate allergological work-up. VIT is performed in a suitable environment and has proved to be safe and effective with various administration protocols, both accelerated and conventional. The prevention of Hymenoptera venom anaphylaxis in patients who have already developed a previous episode is crucial and must be supported by environmental protection interventions and early therapy. Places where one is more likely to encounter insects and risky behaviors should be avoided.https://doi.org/10.1186/s13052-024-01731-9HymenopteraVenomAllergyChildrenPediatrics |
| spellingShingle | Mattia Giovannini Francesca Mori Simona Barni Francesca Saretta Stefania Arasi Riccardo Castagnoli Lucia Liotti Carla Mastrorilli Luca Pecoraro Lucia Caminiti Gunter Johannes Sturm Gian Luigi Marseglia Michele Miraglia del Giudice Elio Novembre Hymenoptera venom allergy in children Italian Journal of Pediatrics Hymenoptera Venom Allergy Children Pediatrics |
| title | Hymenoptera venom allergy in children |
| title_full | Hymenoptera venom allergy in children |
| title_fullStr | Hymenoptera venom allergy in children |
| title_full_unstemmed | Hymenoptera venom allergy in children |
| title_short | Hymenoptera venom allergy in children |
| title_sort | hymenoptera venom allergy in children |
| topic | Hymenoptera Venom Allergy Children Pediatrics |
| url | https://doi.org/10.1186/s13052-024-01731-9 |
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