Guan Kai, Li Li-Sha, Yin Jia
Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 2016 Sep 5;129(17):2091-5. doi: 10.4103/0366-6999.189056.
Venom allergy is significantly underestimated in China. Venom-specific IgE may not provide accurate clinical reactions. Our conducted retrospective analysis observes alternative diagnostic considerations in assessing confirmation and severity of honeybee venom allergy.
Retrospective review of honeybee venom allergy versus nonallergy patients presented with positive honeybee venom (i1) sIgE results. According to clinically observed reactions caused by a honeybee sting, patients were divided into three groups. Patient residence and exposure types were analyzed. The sIgE/T-IgE among allergy and control groups was compared.
Gender ratio male:female was 32:22; median age was 39 years (31, 50). 48% (26/54) of patients live in urban areas, 52% (28/54) in rural areas. Based on bee sting reactions, patients were divided into common localized reactions (32/54), large localized reactions (7/54), and systemic reactions (15/54). In the systemic reaction group, patients presented as Type II (6/15), Type III (6/15). There is significant difference (P < 0.001) between the three groups in regards to exposure types. In the systemic reaction group, 8.7% (13/15) of patients are beekeepers. A significant difference (P < 0.001) was observed between allergic and control groups based on sIgE/T-IgE results. As well as significant difference observed between the systemic reaction group to the other two reaction groups in regards to sIgE/T-IgE results. Six systemic reaction patients presented with large localized reactions before onset of system symptoms 1 month to 1 year of being stung.
Occupational exposure is the most common cause in honeybee venom allergy induced systemic reactions. The use of sIgE/T-IgE results is a useful diagnostic parameter in determining honeybee venom allergy.
在中国,蜂毒过敏被严重低估。蜂毒特异性IgE可能无法准确反映临床反应。我们进行的回顾性分析观察了在评估蜜蜂毒液过敏的确诊和严重程度时的其他诊断考量因素。
对蜜蜂毒液(i1)sIgE结果呈阳性的蜜蜂毒液过敏患者与非过敏患者进行回顾性研究。根据临床观察到的蜜蜂蜇伤引起的反应,将患者分为三组。分析患者的居住地和接触类型。比较过敏组和对照组之间的sIgE/T-IgE。
男女比例为32:22;中位年龄为39岁(31,50)。48%(26/54)的患者居住在城市地区,52%(28/54)居住在农村地区。根据蜜蜂蜇伤反应,患者分为常见局部反应(32/54)、大片局部反应(7/54)和全身反应(15/54)。在全身反应组中,患者表现为II型(6/15)、III型(6/15)。三组在接触类型方面存在显著差异(P < 0.001)。在全身反应组中,8.7%(13/15)的患者是养蜂人。根据sIgE/T-IgE结果,过敏组和对照组之间存在显著差异(P < 0.001)。全身反应组与其他两个反应组在sIgE/T-IgE结果方面也存在显著差异。6例全身反应患者在被蜇伤1个月至1年出现全身症状之前表现为大片局部反应。
职业接触是蜜蜂毒液过敏引起全身反应的最常见原因。sIgE/T-IgE结果的应用是确定蜜蜂毒液过敏的有用诊断参数。