Identifying and managing Hymenoptera venom allergy

Abstract

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. Treatment for local reactions involves the use of cold packs, antihistamines, analgesia and topical corticosteroids to help alleviate swelling, pain and pruritus. Venom immunotherapy is the treatment of choice for reducing the incidence of future anaphylactic reactions in individuals who have signs of respiratory obstruction or hypotension. Venom immunotherapy is the most effective treatment in reduction of life-threatening reactions to venom, and can improve quality of life for individuals. Treatment should only be provided by experienced staff who are able to provide emergency care for anaphylaxis and life-threatening episodes. A risk assessment to deliver treatment should be undertaken before treatment is commenced.

Keywords: Hymenoptera; allergy; anaphylaxis; immunoglobulin E-mediated hypersensitivity; immunotherapy; systemic allergic reactions; venom allergy.