Current practices in diagnosis of Hymenoptera venom allergy in Poland.

INTRODUCTION

Hymenoptera venom allergy (HVA) is associated with a high risk of anaphylaxis. Effective treatment of HVA patients requires allergologists' familiarity with the latest HVA recommendations.

AIM

Evaluation of current practices in HVA diagnosis in Poland.

MATERIAL AND METHODS

A survey questionnaire was conducted in 32 HVA centres in Poland.

RESULTS

The response rate was 97%. There were 1829 patients evaluated due to HVA in 2015. Sixty six percent ( = 21) of the centres used skin prick tests, out which 90% ( = 19) used 100 µg/ml of the venom extract as the highest concentration. All the centres performed intradermal tests (IDT) and serum specific IgE (sIgE), an initial diagnostic tool in 91% ( = 29). The highest venom concentration in IDT was 1 µg/ml in 75% ( = 24), 0.1 µg/ml in 16% ( = 5), 0.01 µg/ml in 3% ( = 1) and 10 µg/ml in 6% ( = 2). Baseline serum tryptase was assessed in 84% of the centres ( = 27), out of which 53% ( = 17) tested all their patients, whereas 31% ( = 10) checked only those with life-threatening reactions. In case of negative IDT/sIgE, 59% of the centres ( = 19) performed components evaluation, while 19% ( = 6) did the basophil activation test. In case of no identification of the culprit insect and sensitization to both venoms, VIT employed venom with higher sIgE.

CONCLUSIONS

Most allergology centres in Poland follow HVA guidelines. We identified two inaccuracies in their HVA management including non-adequate venom concentration in IDT and a false belief in correspondence between sIgE concentration and severity of allergic reactions.