In-hospital sting challenge in insect venom-allergic patients after stopping venom immunotherapy Lars Haugaard, Awhus, Dcnmd
MD,* Ole F. H. Nsrregaard,
MD,**
and Ronald Dahl, MD*
Immunotherapy (IT) in Laenom-allergic patients has been demonstrated to provide a high!\ ejficirnt protection from snlere reaction.s to a re-.sting. It is not known whether this protection t+,ill persist after IT is stopped in patients with remaining venom sensitivig. In 25 adult patients ,cith a pre\+ou.s severe .sl.stemic reaction to a Hymenoptera insect sting, 28 in-hospitul sting challenges crJter stopping IT resulted in no sxstemic reactions. The mean duration of venom IT IZYIS42.8 months (range. 36 to 83 months), and the mean time interval,from the time IT was stopped until sting challenge NW. in mean, 25.2 month.s (range. 12 to 36 months). The mean rsenom-specific IgE after stopping IT ~~1s2.4 PRUlml (range. 0 to 16.9 PRUlml), at the day c~f .sting challenge. 2.7 PRUlmI (range. 0 to 22 PRUiml), and 2 weeks later, 2.4 PRUlml (range, 0.02 to 27.8 PRUlml). Thcsc changes in IgE wrre not .signjficant. Venom-.spec$c IgG l.oll(.elltr(ltioll when IT MYISstopped was 64 PU I ml (range. 20 to I44 PUlml). decreasing .sign[jicantly to the da! of sting challenge to 41. I PUI ml (range, I3 to X4 Pillml). and 2 weeks later, a .sign[jicant increasr to a mean of53.5 PUlml (range. I2 to 117 PUlml) was,fiiund. Our results suggest that \~mom IT ma! be stoppcld rrfter 3 years. regardless of the level of specific antihodie.s. To confirm this jinding. a larger number of patients should be studied. ( .I ALLERGY CLlN IMMU,VOL
199/;87:h99-702.)
IT with purified extracts of Hymenoptera insect venom has been used in the treatment of patients with IgE-mediated SRs to insect stings since it was demonstrated that this treatment is superior to IT with whole-body extracts.‘. ’ Adults receiving sufficient maintenance doses of venom extract have a risk of an SR to an insect sting of
MD,* Ole F. H. Nsrregaard,
MD,**
and Ronald Dahl, MD*
Immunotherapy (IT) in Laenom-allergic patients has been demonstrated to provide a high!\ ejficirnt protection from snlere reaction.s to a re-.sting. It is not known whether this protection t+,ill persist after IT is stopped in patients with remaining venom sensitivig. In 25 adult patients ,cith a pre\+ou.s severe .sl.stemic reaction to a Hymenoptera insect sting, 28 in-hospitul sting challenges crJter stopping IT resulted in no sxstemic reactions. The mean duration of venom IT IZYIS42.8 months (range. 36 to 83 months), and the mean time interval,from the time IT was stopped until sting challenge NW. in mean, 25.2 month.s (range. 12 to 36 months). The mean rsenom-specific IgE after stopping IT ~~1s2.4 PRUlml (range. 0 to 16.9 PRUlml), at the day c~f .sting challenge. 2.7 PRUlmI (range. 0 to 22 PRUiml), and 2 weeks later, 2.4 PRUlml (range, 0.02 to 27.8 PRUlml). Thcsc changes in IgE wrre not .signjficant. Venom-.spec$c IgG l.oll(.elltr(ltioll when IT MYISstopped was 64 PU I ml (range. 20 to I44 PUlml). decreasing .sign[jicantly to the da! of sting challenge to 41. I PUI ml (range, I3 to X4 Pillml). and 2 weeks later, a .sign[jicant increasr to a mean of53.5 PUlml (range. I2 to 117 PUlml) was,fiiund. Our results suggest that \~mom IT ma! be stoppcld rrfter 3 years. regardless of the level of specific antihodie.s. To confirm this jinding. a larger number of patients should be studied. ( .I ALLERGY CLlN IMMU,VOL
199/;87:h99-702.)
IT with purified extracts of Hymenoptera insect venom has been used in the treatment of patients with IgE-mediated SRs to insect stings since it was demonstrated that this treatment is superior to IT with whole-body extracts.‘. ’ Adults receiving sufficient maintenance doses of venom extract have a risk of an SR to an insect sting of
