[The special problem of insect venom allergy in childhood].

Natural history of hymenoptera sting allergy is less life threatening in children than in adults. We evaluated a commonly used risk score (allergic reaction to the index sitting, sensitization measured by skin prick test and specific IgE, and specific IgG - maximal 8 points) for its predictability of forthcoming allergic reactions. 93 children with low scores (less than 7 points) experienced stings in field, 96% were save from severe systemic reactions. Of 119 children with high scores (greater than 6 points) receiving rush hyposensitization only 32% developed systemic reactions. We conclude that the score appropriately identifies individuals not to be hyposensitized, but that it overestimates the number of children with a need for hyposensitization. We therefore developed a diagnostic scheme including challenge stings to identify those children who really need hyposensitization.