Schwartz H J, Squillace D L, Sher T H, Teigland J D, Yunginger J W
Am J Clin Pathol. 1986 May;85(5):607-10. doi: 10.1093/ajcp/85.5.607.
The purpose of this study was to extend previous findings of elevated antivenom IgE antibodies in sera from persons experiencing fatal insect sting reactions. Elevated IgE antibodies to at least one venom were measured in sera from four of six witnessed fatal cases of sting anaphylaxis; in one of two unwitnessed cases of sudden, unexpected death in which the circumstances suggested possible sting anaphylaxis; and in one unwitnessed death where autopsy findings of massive swelling of the pharynx and larynx suggested anaphylaxis. Conversely, no elevated IgE antibodies were measured in serum from a boy who received more than 40 yellow jacket stings with subsequent cardiopulmonary arrest, from which he was successfully resuscitated. Measurement of IgE antibodies in postmortem sera may not only provide confirmatory evidence of fatal anaphylaxis following witnessed insect stings, but also may provide useful additional data in unwitnessed deaths where the clinical history or autopsy findings suggest unexplained anaphylaxis.
本研究的目的是扩展先前的研究结果，即经历致命昆虫叮咬反应的人的血清中抗蛇毒IgE抗体升高。在6例有目击的叮咬过敏致死病例中的4例、2例无目击的突然意外死亡病例（其中情况提示可能为叮咬过敏）中的1例以及1例无目击死亡病例（尸检发现咽喉部大量肿胀提示过敏）中，检测到至少一种毒液的IgE抗体升高。相反，一名男孩被40多只黄胡蜂蜇伤后出现心肺骤停，但成功复苏，其血清中未检测到IgE抗体升高。检测死后血清中的IgE抗体不仅可以为有目击的昆虫叮咬后致命过敏反应提供确证，还可以为临床病史或尸检结果提示不明原因过敏的无目击死亡病例提供有用的额外数据。
