The authors treated 22 adults patients with histories of systemic hypersensitivity to hymenoptera with venom extracts using a traditional approach to immunotherapy. Patients had an immunological response consisting of an increase in venom specific IgE and IgG. Twelve patients underwent an uneventful in-hospital insect sting challenge. Injections of venom extract elicited large reactions in 50% of the patients for which subsequent venom dosages were adjusted proportionately to the local reaction. Using this approach, the investigators observed no systemic reactions to venom therapy. They conclude that systemic reactions to venom immunotherapy may be lessened by the adjustment of venom dose after local reactions to therapy without a loss of efficacy.
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