General Hospital Civitanova Marche, Allergy Unit, Civitanova Marche, Italy.
ASST Pini-CTO, Cardiac/Pulmonary Rehabilitation, Milan, Italy.
Immun Inflamm Dis. 2019 Dec;7(4):258-259. doi: 10.1002/iid3.268. Epub 2019 Sep 7.
The natural history of large local reactions to Hymenoptera stings allowed to estimate the risk to develop a systemic reaction after an initial large local reaction in about 4% of patients. A recently published study claimed that such risk concerns instead around one-fourth of patients. However, such study is flawed by serious imprecision, particularly the unreliable identification by patients of the culprit insect, as well as the dubious identification of the causative venom in multisensitized patients. Also, the authors criticized previous studied because of the limited number of patients, while they included in the study 662 patients. Indeed, when only patients clearly restung by the same insect according to their history data were considered, the number of patients fell to 35. These data are unable to change the current shared concept on the low risk of systemic reactions in patients with initial large local reaction.
大型局部反应对膜翅目昆虫叮咬的自然史允许估计初始大局部反应后发生全身反应的风险，约 4%的患者。最近发表的一项研究声称，这种风险涉及约四分之一的患者。然而，这项研究存在严重的不精确性，特别是患者对罪魁祸首昆虫的不可靠识别，以及多敏患者中可疑的致毒液识别。此外，作者还批评了以前的研究，因为患者数量有限，而他们纳入了 662 名患者的研究。事实上，当仅根据其病史数据明确由同一昆虫重新叮咬的患者被认为是全身性反应的低风险时，患者人数减少到 35 人。这些数据无法改变当前对初始大局部反应患者发生全身性反应的低风险的共识。
