Venom allergen immunotherapy in children

Abstract

Background

Hymenoptera venom allergy (HVA) is a potentially life-threatening reaction to stings from Apis mellifera (honey bee) or Vespula (yellowjacket).

Objective

To evaluate re-sting reactions during or after venom immunotherapy (VIT) and the impact of VIT on the quality of life (QoL) of children with HVA.

Methods

The study included 78 patients who experienced grade III, IV, or V systemic reactions and underwent conventional subcutaneous VIT. The modified World Allergy Organization grading system was used to grade the systemic reactions. Patients were asked whether they were re-stung by the culprit Hymenoptera to which they were allergic, and the re-sting reactions were evaluated using a questionnaire. The Turkish version of the Vespid Allergy Quality of Life Questionnaire was used to assess QoL.

Results

A total of 17 children (21.8%) were allergic to honey bee and 61 (78.2%) to yellowjacket. The most common symptoms before VIT were dyspnea (93.6%), angioedema (93.6%), and generalized urticaria (67.9%); 43 patients (55.1%) were re-stung by the culprit Hymenoptera: 19 during VIT and 24 after VIT; and 7 of 19 patients (36.8%) and 1 of 24 patients (4.1%) who were re-stung reported systemic re-sting reactions during and after VIT, respectively. The median Vespid Allergy Quality of Life Questionnaire score was 2.82 (IQR: 2.07-3.51) before VIT and 5.62 (IQR: 4.61-6.25) after VIT.

Conclusion

Children with HVA who had received or were receiving VIT showed a substantial reduction in the severity of re-sting reactions. VIT led to a significant improvement in the QoL of children with HVA.