Hymenoptera venom allergy in children and adolescents.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 100936359 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-6322 (Electronic) Linking ISSN: 14736322 NLM ISO Abbreviation: Curr Opin Allergy Clin Immunol Subsets: MEDLINE

Original Publication: Hagerstown, Md. : Lippincott Williams & Wilkins, c2001-

Hymenoptera*/immunology ; Desensitization, Immunologic*/methods ; Arthropod Venoms*/immunology ; Arthropod Venoms*/adverse effects ; Insect Bites and Stings*/immunology ; Insect Bites and Stings*/therapy ; Insect Bites and Stings*/epidemiology ; Insect Bites and Stings*/diagnosis ; Anaphylaxis*/epidemiology ; Anaphylaxis*/immunology ; Anaphylaxis*/prevention & control ; Anaphylaxis*/diagnosis ; Anaphylaxis*/etiology ; Anaphylaxis*/therapy; Humans ; Child ; Adolescent ; Animals ; Hypersensitivity/immunology ; Hypersensitivity/therapy ; Hypersensitivity/epidemiology ; Hypersensitivity/diagnosis ; Allergens/immunology ; Incidence ; Prevalence ; Quality of Life

Purpose of Review: This review will identify and summarize the published existing data pertaining specifically to Hymenoptera venom allergy in children and adolescents, highlighting the major studies currently available on venom immunotherapy (VIT) and its prognosis in children.
Recent Findings: The current review covers the incidence and prevalence of Hymenoptera venom allergy (HVA) in children, factors influencing occurrence and severity of reactions (age, sex, comorbidities, etc.), indications to perform diagnostic tests and start VIT in children, different existing VIT protocols and their safety and efficacy.
Summary: Hymenoptera venom allergy is the second most common cause of anaphylaxis in children and it considerably affects quality of life. Cutaneous reactions are the most prevalent clinical presentation in children who usually have a more favourable prognosis than adult patients. However, studies on HVA in children and adolescents are still limited. Currently VIT is the only treatment able to modify the natural history of HVA in adults as well as in children, and to protect patients from systemic reactions after subsequent stings.
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Grabenhenrich LB, Dölle S, Moneret-Vautrin A, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. J Allergy Clin Immunol 2016; 137:1128.e1–1137.e1.
Schuberth KC, Lichtenstein LM, Kagey-Sobotka A, et al. Epidemiologic study of insect allergy in children. II. Effect of accidental stings in allergic children. J Pediatr 1983; 102:361–365.
Golden DBK, Kagey-Sobotka A, Norman PS, et al. Outcomes of allergy to insect stings in children, with and without venom immunotherapy. N Engl J Med 2004; 351:668–674.
Jennings A, Duggan E, Perry IJ, Hourihane JO. Epidemiology of allergic reactions to hymenoptera stings in Irish school children. Pediatr Allergy Immunol 2010; 21:1166–1170.
Von Moos S, Graf N, Johansen P, et al. Risk assessment of Hymenoptera re-sting frequency: implications for decision-making in venom immunotherapy. Int Arch Allergy Immunol 2013; 160:86–92.
Stritzke AI, Eng PA. Age-dependent sting recurrence and outcome in immunotherapy-treated children with anaphylaxis to Hymenoptera venom. Clin Exp Allergy 2013; 43:950–955.
Floyd ML, Adams KE, Golden DBK. Updates and recent advances on venom immunotherapy. Curr Treat Options Allergy 2023; 1–19. doi: 10.1007/s40521-023-00336-7. [Epub ahead of print]. (PMID: 10.1007/s40521-023-00336-7.)
Clifford D, Ni Chaoimh C, Stanley E, O’B Hourihane J. A longitudinal study of hymenoptera stings in preschool children. Pediatr Allergy Immunol 2019; 30:93–98.
Martínez-Cañavate A, Tabar AI, Eseverri JL, et al. An epidemiological survey of hymenoptera venom allergy in the Spanish paediatric population. Allergol Immunopathol (Madr) 2010; 38:259–262.
Feás X, Vidal C, Remesar S. What we know about sting-related deaths? Human fatalities caused by hornet, wasp and bee stings in Europe (1994-2016). Biology (Bssel) 2022; 11:282.
Prado M, Quirós D, Lomonte B. Mortality due to Hymenoptera stings in Costa Rica, 1985-2006. Rev Panam Salud Publica 2009; 25:389–393.
Ring J, Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet 1977; 1:466–469.
Mueller HL. Diagnosis and treatment of insect sensitivity. J Asthma Res 1966; 3:331–333.
Muraro A, Fernandez-Rivas M, Beyer K, et al. The urgent need for a harmonized severity scoring system for acute allergic reactions. Allergy 2018; 73:1792–1800.
Bilò M, Pravettoni V, Bignardi D, et al. Hymenoptera venom allergy: management of children and adults in clinical practice. J Investig Allergol Clin Immunol 2019; 29:180–205.
Mullins RJ, Wainstein BK, Barnes EH, et al. Increases in anaphylaxis fatalities in Australia from 1997 to 2013. Clin Exp Allergy 2016; 46:1099–1110.
Carballada González FJ, Crehuet Almirall M, Manjón Herrero A, et al. Hymenoptera venom allergy: characteristics, tolerance and efficacy of immunotherapy in the paediatric population. Allergol Immunopathol (Madr) 2009; 37:111–115.
Ruëff F, Bauer A, Becker S, et al. Diagnosis and treatment of Hymenoptera venom allergy: S2k Guideline of the German Society of Allergology and Clinical Immunology (DGAKI) in collaboration with the Arbeitsgemeinschaft für Berufs- und Umweltdermatologie e.V. (ABD), the Medical Association of German Allergologists (AeDA), the German Society of Dermatology (DDG), the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNOKC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Allergy and Environmental Medicine (GPA), German Respiratory Society (DGP), and the Austrian Society for Allergy and Immunology (ÖGAI). Allergol Sel 2023; 7:154–190.
Tan JW, Campbell DE. Insect allergy in children. J Paediatr Child Health 2013; 49:E381–E387.
Solley GO. Stinging and biting insect allergy: an Australian experience. Ann Allergy Asthma Immunol 2004; 93:532–537.
Blank S, Haemmerle S, Jaeger T, et al. Prevalence of Hymenoptera venom allergy and sensitization in the population-representative German KORA cohort. Allergol J Int 2019; 28:183–191.
Golden DB, Marsh DG, Kagey-Sobotka A, et al. Epidemiology of insect venom sensitivity. JAMA 1989; 262:240–244.
Biló BM, Rueff F, Mosbech H, et al. EAACI Interest Group on Insect Venom Hypersensitivity. Diagnosis of Hymenoptera venom allergy. Allergy 2005; 60:1339–1349.
Schiener M, Graessel A, Ollert M, et al. Allergen-specific immunotherapy of Hymenoptera venom allergy – also a matter of diagnosis. Hum Vaccines Immunother 2017; 13:2467–2481.
Bilò BM, Bonifazi F. Hymenoptera venom immunotherapy. Immunotherapy 2011; 3:229–246.
Möbs C, Ipsen H, Mayer L, et al. Birch pollen immunotherapy results in long-term loss of Bet v 1–specific TH2 responses, transient TR1 activation, and synthesis of IgE-blocking antibodies. J Allergy Clin Immunol 2012; 130:1108.e6–1116.e6.
Cichocka-Jarosz E, Stobiecki M, Brzyski P, et al. Simplification of intradermal skin testing in Hymenoptera venom allergic children. Ann Allergy Asthma Immunol 2017; 118:326–332.
Severino MG, Campi P, Macchia D, et al. European Polistes venom allergy. Allergy 2006; 61:860–863.
Alfaya Arias T, Soriano Gómis V, Soto Mera T, et al. Hymenoptera Allergy Committee of the SEAIC. Key issues in Hymenoptera venom allergy: an update. J Investig Allergol Clin Immunol 2017; 27:19–31.
Korošec P, Šilar M, Eržen R, et al. Clinical routine utility of basophil activation testing for diagnosis of hymenoptera-allergic patients with emphasis on individuals with negative venom-specific IgE antibodies. Int Arch Allergy Immunol 2013; 161:363–368.
Bonifazi F, Jutel M, Biló BM, et al. the EAACI Interest Group on Insect Venom Hypersensitivity. Prevention and treatment of hymenoptera venom allergy: guidelines for clinical practice. Allergy 2005; 60:1459–1470.
Muraro A, Roberts G, Worm M, et al. EAACI Food Allergy and Anaphylaxis Guidelines Group. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy 2014; 69:1026–1045.
Bilò MB, Cichocka-Jarosz E, Pumphrey R, et al. Self-medication of anaphylactic reactions due to Hymenoptera stings—an EAACI Task Force Consensus Statement. Allergy 2016; 71:931–943.
Muraro A, Roberts G, Clark A, et al. EAACI Task Force on Anaphylaxis in Children. The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology. Allergy 2007; 62:857–871.
Pumphrey RS. Lessons for management of anaphylaxis from a study of fatal reactions. Clin Exp Allergy 2000; 30:1144–1150.
Golden DBK. Insect sting allergy and venom immunotherapy: a model and a mystery. J Allergy Clin Immunol 2005; 115:439–447.
Karagol HIE, Bakirtas A, Yilmaz O, et al. Comparison of moderate to severe systemic reactions with honeybee and wasp in children. Int Forum Allergy Rhinol 2014; 4:548–554.
Esenboga S, Ocak M, Cetinkaya PG, et al. Physicians prescribe adrenaline autoinjectors, do parents use them when needed? Allergol Immunopathol (Madr) 2020; 48:3–7.
Topal E, Bakirtas A, Yilmaz O, et al. A real-life study on acquired skills from using an adrenaline autoinjector. Int Arch Allergy Immunol 2013; 160:301–306.
Hellstrom A, Eriksson K, Efraimsson EO, et al. Assessment of self-administered epinephrine during a training session. Acta Paediatr 2011; 100:.
Lichtenstein LM, Valentine MD, Sobotka AK. A case for venom treatment in anaphylactic sensitivity to Hymenoptera sting. N Engl J Med 1974; 290:1223–1227.
Sturm GJ, Varga E -M, Roberts G, et al. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy 2018; 73:744–764.
Pitsios C, Demoly P, Bilò MB, et al. Clinical contraindications to allergen immunotherapy: an EAACI position paper. Allergy 2015; 70:897–909.
Valentine MD, Schuberth KC, Kagey-Sobotka A, et al. The value of immunotherapy with venom in children with allergy to insect stings. N Engl J Med 1990; 323:1601–1603.
Golden DB, Marsh DG, Freidhoff LR, et al. Natural history of Hymenoptera venom sensitivity in adults. J Allergy Clin Immunol 1997; 100 (6 pt 1):760–766.
Saretta F, Giovannini M, Pessina B, et al. Venom immunotherapy protocols in the pediatric population: how to choose? Front Pediatr 2023; 11:1192081.
Johnston N, Belcher J, Preece K, Bhatia R. Review of venom immunotherapy at a regional tertiary paediatric centre. J Paediatr Child Health 2022; 58:1228–1232.
Confino-Cohen R, Rosman Y, Goldberg A. Rush venom immunotherapy in children. J Allergy Clin Immunol Pract 2017; 5:799–803.
Golden D, Kageysobotka A, Valentine M, Lichtenstein L. Dose dependence of Hymenoptera venom immunotherapy. J Allergy Clin Immunol 1981; 67:370–374.
Reisman R, Livingston A. Venom immunotherapy: 10 years of experience with administration of single venoms and 50 μg maintenance doses. J Allergy Clin Immunol 1992; 89:1189–1195.
Houliston L, Nolan R, Noble V, et al. Honeybee venom immunotherapy in children using a 50-μg maintenance dose. J Allergy Clin Immunol 2011; 127:98–99.
Konstantinou GN, Manoussakis E, Douladiris N, et al. A 5-year venom immunotherapy protocol with 50 μg maintenance dose: safety and efficacy in school children. Pediatr Allergy Immunol 2011; 22:393–397.
Gür Çetinkaya P, Esenboğa S, Uysal Soyer Ö, et al. Subcutaneous venom immunotherapy in children. Ann Allergy Asthma Immunol 2018; 120:424–428.
Lockey R, Turkeltaub P, Olive E, et al. The Hymenoptera venom study III: safety of venom immunotherapy2. J Allergy Clin Immunol 1990; 86:775–780.
Glaeser A, Müller C, Bode S. Anaphylactic reactions in the build-up phase of rush immunotherapy for bee venom allergy in pediatric patients: a single-center experience. Clin Mol Allergy 2022; 20:4.
Droitcourt C, Ponvert C, Dupuy A, et al. Efficacy of a short pretreatment with omalizumab in children with anaphylaxis to hymenoptera venom immunotherapy: a report of three cases. Allergol Int 2019; 68:268–269.
Golden DBK, Demain J, Freeman T, et al. Stinging insect hypersensitivity. Ann Allergy Asthma Immunol 2017; 118:28–54.
Ertoy Karagol HI, Bakirtas A, Yilmaz O, et al. Long-term follow-up of re-sting reactions in children with moderate to severe venom hypersensitivity. Eur J Pediatr 2015; 174:891–896.
Albuhairi S, El Khoury K, Yee C, et al. A twenty-two-year experience with Hymenoptera venom immunotherapy in a US pediatric tertiary care center 1996-2018. Ann Allergy Asthma Immunol 2018; 121:722.e1–728.e1.
Muller U, Berchtold E, Helbling A. Honeybee venom allergy: results of a sting challenge 1 year after stopping successful venom immunotherapy in 86 patients. J Allergy Clin Immunol 1991; 87:702–709.
Aßmus K, Meissner M, Kaufmann R, Valesky EM. Benefits and limitations of sting challenge in hymenoptera venom allergy. Allergol Sel 2021; 5:45–50.
Cardona V, Ferré-Ybarz L, Guilarte M, et al. AdreSCAIC Research Group. Safety of adrenaline use in anaphylaxis: a multicentre register. Int Arch Allergy Immunol 2017; 173:171–177.

0 (Arthropod Venoms)
0 (Allergens)

Date Created: 20240812 Date Completed: 20240829 Latest Revision: 20240829

20240831

10.1097/ACI.0000000000001013

39133153