Rancé F, Abbal M, Brémont F, Dutau G
Service de médecine infantile F (pneumologie, allergologie, mucoviscidose), CHU Purpan, Toulouse, France.
Arch Pediatr. 1999;6 Suppl 1:55S-60S. doi: 10.1016/s0929-693x(99)80247-4.
Incidence of hymenoptera venom allergy in children is about 0.4 to 0.8%. Clinical features usually range from urticaria to anaphylaxis. Fatal reactions can occur but with less frequency than in adults. Allergologic investigations must be performed in children with systemic or generalized reactions after hymenoptera stings, which may lead to venom immunotherapy. Venom immunotherapy is well reported, but protocols differ according to the authors: ultra-rush in 3 h, accelerated in 3 to 5 days and semi-rush in 2 to 8 weeks. Results are always excellent (90 to 100%). We report our experience with 91 children receiving venom immunotherapy. Clinical history and positivity of skin tests indicated immunotherapy. Clinical symptoms were anaphylaxis (15.3%), serious reaction (37.3%) strong reaction (34%), and mild reaction (7.6%). Changes in immunological parameters revealed wide individual variations, not differing from data in the literature, with no correlation with evolution of immunotherapy. Venom immunotherapy appeared with good tolerability in children, whatever the protocol used.
儿童膜翅目昆虫毒液过敏的发生率约为0.4%至0.8%。临床特征通常从荨麻疹到过敏反应不等。虽然可能会发生致命反应,但频率低于成人。对于膜翅目昆虫叮咬后出现全身或全身性反应的儿童,必须进行过敏学检查,这可能会导致毒液免疫治疗。毒液免疫治疗已有充分报道,但不同作者的方案有所不同:3小时内超快速、3至5天内加速、2至8周内半快速。结果总是非常好(90%至100%)。我们报告了91名接受毒液免疫治疗儿童的经验。临床病史和皮肤试验阳性表明需要进行免疫治疗。临床症状为过敏反应(15.3%)、严重反应(37.3%)、强烈反应(34%)和轻度反应(7.6%)。免疫参数的变化显示出个体差异很大,与文献数据无差异,且与免疫治疗的进展无关。无论使用何种方案,毒液免疫治疗在儿童中似乎耐受性良好。