Bousquet J, Ménardo J L, Velasquez G, Michel F B
Clinique des Maladies Respiratories, Centre Hospitalier Universitaire, Montepillier, France.
Ann Allergy. 1988 Jul;61(1):63-8.
Immunotherapy with hymenoptera venoms is safe and effective in most patients but treatment failures have been reported. Five patients experienced systemic symptoms of anaphylaxis when they were in maintenance immunotherapy with honey bee venom. In one case, the patient presented a severe life-threatening reaction when stung by a honey bee. Three others had the development of new clinical sensitivity suggesting a re-sensitization. This occurred in the fifth patient after a severe viral infection. By means of a rush protocol and monthly doses of 200 to 400 micrograms of honey bee venom, the patients were subsequently protected efficiently. In most cases these reactions might have been predicted since patients experienced large local reactions prior to the systemic reactions when allergens were injected. Further, in four cases there was an increased skin test reactivity or raised serum honey bee venom IgE levels or both. In all patients, the levels of serum honey bee venom IgG was under 200 U/mL (IgG Pharmacia RAST).
膜翅目昆虫毒液免疫疗法对大多数患者来说是安全有效的，但也有治疗失败的报道。5例患者在接受蜜蜂毒液维持免疫治疗时出现了过敏反应的全身症状。其中1例患者被蜜蜂蜇伤时出现了严重的危及生命的反应。另外3例出现了新的临床敏感性，提示再次致敏。第5例患者在严重病毒感染后出现了这种情况。通过快速方案和每月200至400微克的蜜蜂毒液剂量，患者随后得到了有效保护。在大多数情况下，这些反应可能是可以预测的，因为患者在注射过敏原时，在出现全身反应之前就经历了严重的局部反应。此外，有4例患者皮肤试验反应性增加或血清蜜蜂毒液IgE水平升高或两者皆有。所有患者血清蜜蜂毒液IgG水平均低于200 U/mL（IgG Pharmacia RAST）。
