Klimek L, Dippold N, Sperl A
Zentrum für Rhinologie und Allergologie, An den Quellen 10, 65183, Wiesbaden, Deutschland.
Universitäts-HNO-Klinik Mannheim, Mannheim, Deutschland.
HNO. 2016 Dec;64(12):927-942. doi: 10.1007/s00106-016-0274-z.
Due to the increasing incidence of hymenoptera venom allergies and the potentially life-threatening reactions, it is important for otolaryngologists working in allergology to have an understanding of modern diagnostic and treatment standards for this allergic disease. Molecular diagnosis with recombinant single allergens from bee and wasp venom components improves the diagnostics of insect venom allergies, particularly in patients with double-positive extract-based test results. Detection of specific sensitizations to bee or wasp venom enables double sensitizations to be better distinguished from cross-reactivity. Based on patient history and test results, the patient is initially advised on avoidance strategies and prescribed an emergency medication kit. Then, the indication for allergen-specific immunotherapy (AIT) is evaluated. The dose-increase phase can be performed using conventional, cluster, rush, or ultra-rush schedules, whereby rapid desensitization (rush AIT) performed in the clinic seems to be particularly effective as initial treatment.
由于膜翅目昆虫毒液过敏的发病率不断上升以及可能危及生命的反应,从事过敏学工作的耳鼻喉科医生了解这种过敏性疾病的现代诊断和治疗标准非常重要。使用来自蜜蜂和黄蜂毒液成分的重组单一变应原进行分子诊断可改善昆虫毒液过敏的诊断,特别是对于基于提取物的检测结果呈双阳性的患者。检测对蜜蜂或黄蜂毒液的特异性致敏能够更好地区分双重致敏与交叉反应。根据患者病史和检测结果,首先建议患者采取避免策略并开具急救药盒。然后,评估变应原特异性免疫疗法(AIT)的适应症。剂量增加阶段可以采用传统、分组、快速或超快速方案进行,其中在诊所进行的快速脱敏(快速AIT)作为初始治疗似乎特别有效。