Background: The direct comparison between children and adults with Hymenoptera venom anaphylaxis (HVA) has never been extensively reported. Severe HVA with IgE-documented mechanism is the recommendation for venom immunotherapy, regardless of age.

Objective: To determine the differences in the basic diagnostic profile between children and adults with severe HVA and its practical implications.

Methods: We reviewed the medical records of 91 children and 121 adults.

Results: Bee venom allergy was exposure dependent, regardless of age (P < .001). Atopy was more common in children (P = .01), whereas cardiovascular comorbidities were present almost exclusively in adults (P = .001). In the bee venom allergic group, specific IgE levels were significantly higher in children (29.5 kU/L; interquartile range, 11.30-66.30 kU/L) compared with adults (5.10 kU/L; interquartile range, 2.03-8.30 kU/L) (P < .001). Specific IgE levels for culprit insect venom were higher in bee venom allergic children compared with the wasp venom allergic children (P < .001). In adults, intradermal tests revealed higher sensitivity, accompanied by larger area of skin reactions, regardless of type of venom. At concentrations lower than 0.1 μg/mL, 16% of wasp venom allergic children and 39% of bee venom allergic children had positive intradermal test results. The median tryptase level was significantly higher in adults than in children for the entire study group (P = .002), as well as in bee (P = .002) and wasp venom allergic groups (P = .049).

Conclusion: The basic diagnostic profile in severe HVA reactors is age dependent. Lower skin test reactivity to culprit venom in children may have practical application in starting the intradermal test procedure with higher venom concentrations.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.anai.2016.11.006DOI Listing

Publication Analysis

Top Keywords

venom allergic
28
allergic children
20
bee venom
16
venom
14
children
12
severe hva
12
wasp venom
12
hymenoptera venom
8
children adults
8
basic diagnostic
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!