Müller Ulrich R, Ring Johannes
Allergy Division, Department of Medicine, Ziegler Hospital, Bern, Switzerland.
Department of Dermatology and Allergy, Technical University, Munich, Germany, and Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
J Allergy Clin Immunol Pract. 2015 May-Jun;3(3):324-8; quiz 329-30. doi: 10.1016/j.jaip.2014.11.018.
Stings by Hymenoptera (honey bees, vespids, ants) can cause systemic allergic reactions (SARs). Venom immunotherapy (VIT) is highly effective and reduces an allergic patient's risk of a recurrent SAR to less than 5-20%. The risk of a recurrent SAR to a re-sting decreases the longer VIT is continued. The recommended duration of VIT is at least 3 to 5 years.
Risk factors for recurrent SARs to a sting after stopping VIT have been identified and discussed: Recommendations concerning stopping VIT: For patients without any of the identified risk factors, VIT should be continued for 5 rather than 3 years. In patients with definite risk factors, a longer duration of VIT has to be discussed before stopping it. In mast cell disorders, VIT for life is recommended. Because of the residual risk of SARs after VIT, all patients are advised to carry an epinephrine autoinjector indefinitely and to continue to take measures to avoid Hymenoptera stings.
膜翅目昆虫（蜜蜂、黄蜂、蚂蚁）蜇伤可引起全身过敏反应（SARs）。毒液免疫疗法（VIT）非常有效，可将过敏患者复发性SAR的风险降低至5%-20%以下。继续进行VIT的时间越长，再次被蜇后发生复发性SAR的风险越低。VIT的推荐疗程至少为3至5年。
已确定并讨论了停止VIT后蜇伤导致复发性SAR的风险因素：关于停止VIT的建议：对于没有任何已确定风险因素的患者，VIT应持续5年而非3年。对于有明确风险因素的患者，在停止VIT之前必须讨论更长的VIT疗程。在肥大细胞疾病中，建议终身进行VIT。由于VIT后仍有SAR的残留风险，建议所有患者无限期携带肾上腺素自动注射器，并继续采取措施避免被膜翅目昆虫蜇伤。
