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Comment
. 2019 Dec;7(4):258-259.
doi: 10.1002/iid3.268. Epub 2019 Sep 7.

Large local reaction to Hymenoptera stings: Sound studies are needed to change a shared concept

Stefano Pucci  1 , Cristoforo Incorvaia  2 , Antonino Romano  3
Affiliations
Comment

Large local reaction to Hymenoptera stings: Sound studies are needed to change a shared concept

Stefano Pucci et al. Immun Inflamm Dis. 2019 Dec.

Abstract

The natural history of large local reactions to Hymenoptera stings allowed to estimate the risk to develop a systemic reaction after an initial large local reaction in about 4% of patients. A recently published study claimed that such risk concerns instead around one-fourth of patients. However, such study is flawed by serious imprecision, particularly the unreliable identification by patients of the culprit insect, as well as the dubious identification of the causative venom in multisensitized patients. Also, the authors criticized previous studied because of the limited number of patients, while they included in the study 662 patients. Indeed, when only patients clearly restung by the same insect according to their history data were considered, the number of patients fell to 35. These data are unable to change the current shared concept on the low risk of systemic reactions in patients with initial large local reaction.

Keywords: Hymenoptera venom allergy; culprit insects; large local reactions; natural history; systemic reactions.

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Comment on

  • Large local reactions to Hymenoptera stings: Outcome of re-stings in real life.
    Bilò MB, Martini M, Pravettoni V, Bignardi D, Bonadonna P, Cortellini G, Kosinska M, Macchia D, Mauro M, Meucci E, Nittner-Marszalska M, Patella V, Pio R, Quercia O, Reccardini F, Ridolo E, Rudenko M, Severino M. Bilò MB, et al. Allergy. 2019 Oct;74(10):1969-1976. doi: 10.1111/all.13863. Epub 2019 May 28. Allergy. 2019. PMID: 31074868

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