Reisman R E, Osur S L
Buffalo General Hospital, Department of Medicine, State University of New York at Buffalo 14203.
Ann Allergy. 1987 Dec;59(6):429-32.
Over a 10-year period, 750 patients were evaluated because of anaphylaxis following insect stings. Sixty-five patients were identified who had reactions after their first sting exposure. Their clinical features and symptoms of anaphylaxis were the same as the much larger group of patients who had allergic reactions following prior exposure to insect stings. When evaluated following the sting reaction, the majority of these patients had venom-specific IgE detected by skin test or in the serum by the RAST. Fifty-three re-stings occurred in 31 patients. In untreated or whole body extract-treated patients, there were 43 re-stings resulting in 13 reactions. There were no reactions following 10 re-stings in venom-treated patients. In a subgroup of 15 patients with undetectable venom-specific IgE, there were 16 re-stings in eight patients, leading to three systemic reactions. The occurrence of allergic reactions following first sting exposure adds further support to the thesis that some sting reactions are non-IgE-mediated.
在10年期间，750名因昆虫叮咬后发生过敏反应的患者接受了评估。65名患者在首次接触叮咬后出现了反应。他们过敏反应的临床特征和症状与之前接触昆虫叮咬后发生过敏反应的规模大得多的患者群体相同。在叮咬反应后进行评估时，这些患者中的大多数通过皮肤试验或RAST在血清中检测到了毒液特异性IgE。31名患者发生了53次再次叮咬。在未治疗或接受全身提取物治疗的患者中，有43次再次叮咬导致13次反应。毒液治疗的患者在10次再次叮咬后没有出现反应。在15名毒液特异性IgE检测不到的患者亚组中，8名患者发生了16次再次叮咬，导致3次全身反应。首次接触叮咬后发生过敏反应进一步支持了某些叮咬反应是非IgE介导的这一论点。
