[Chronic urticaria as an atypical reaction after a vespid bite].

Patricia Andrade-Garbán, María de Los Angeles González-Labrador, Marta Goyanes-Malumbres, Mariela Brandoni-Petrone, Teresa Alfaya-Arias
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Abstract

Background: Hymenoptera stings can produce IgE-mediated reactions, toxic reactions, or atypical reactions, which are rare. Cold urticaria has been described among the cutaneous manifestations in the atypical ones, but there is only one case of chronic urticaria.

Case report: A 56-year-old female patient experienced palmoplantar pruritus and generalized urticaria 60 minutes after two vespid stings, requiring medical assistance and several cycles of home treatment with oral antihistamines and corticosteroids for resolution in 12 weeks. Allergological studies showed normal tryptase and primary sensitization to Polistes dominula venom. Given the patient's profession, venom immunotherapy was started with Polistes dominula 100% without recurrence of urticaria after its administration.

Conclusions: We present a case of IgE-mediated systemic reaction followed by self-limited chronic urticaria, related chronologically to the same vespid sting trigger.

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[慢性荨麻疹是被蝰蛇咬伤后的非典型反应]。
背景:膜翅目昆虫蜇伤可产生 IgE 介导的反应、毒性反应或非典型反应,但这些反应都很罕见。在非典型反应的皮肤表现中,有冷性荨麻疹的描述,但只有一例慢性荨麻疹:病例报告:一名 56 岁的女性患者在两次被蝰蛇蜇伤 60 分钟后出现掌跖瘙痒和全身性荨麻疹,需要医疗救助,并在家中使用口服抗组胺药和皮质类固醇激素进行了几个周期的治疗,才在 12 周内缓解。过敏学研究显示,患者的胰蛋白酶正常,对多疣蚜虫毒有原发性过敏反应。考虑到患者的职业,开始使用多疣梭子蟹毒液免疫疗法,100%的多疣梭子蟹毒液免疫疗法后荨麻疹没有复发:我们介绍了一例由 IgE 介导的全身反应,随后出现自限性慢性荨麻疹的病例,从时间上看,该病例与同一蝮蛇蜇伤诱因有关。
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[Adenovirus-related acute liver failure treated with intravenous immunoglobulin]. [Allergic contact dermatitis due to Furacin®]. [Chronic urticaria as an atypical reaction after a vespid bite]. [Epidemiological profile of allergic respiratory disease in Mexican children]. [Knowledge of mothers of children under 5 years of age about vaccination schedule].
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