普通人群及系统性肥大细胞增多症患者中红火蚁毒液过敏反应的患病率。
Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis.
作者信息
McMurray Jeremy C, Schornack Brandon J, Adams Karla E, McCoy Robert L, Marshall Amanda K, Brunader Janet A, Maric Irina, Metcalfe Dean D, Boggs Nathan A
机构信息
Allergy & Immunology Service, Walter Reed National Military Medical Center, Bethesda, MD, United States.
Department of Pediatrics, Uniformed Services University, Bethesda, MD, United States.
出版信息
Front Allergy. 2025 Mar 31;6:1570123. doi: 10.3389/falgy.2025.1570123. eCollection 2025.
BACKGROUND
Stinging Hymenoptera can induce fatal anaphylaxis, especially in patients with systemic mastocytosis. Fire ants, and from South America have recently colonized three continents. Prevalence of fire ant-venom anaphylaxis in the general population and in systemic mastocytosis is unknown. The aim was to determine fire ant-venom anaphylaxis prevalence among Tricare beneficiaries and those with systemic mastocytosis.
METHODS
We queried the beneficiary immunotherapy prescription database for patients who received immunotherapy with Hymenoptera venom or fire ant whole-body extract and the Tricare beneficiary population health registry database for patients with an ICD-10 code for Hymenoptera venom allergy (HVA). Greater than 95% of the beneficiary population were patients living in the United States. Chart review of a random sample of 150 patients linked to a HVA ICD-10 code was performed to determine the percent of patients with Hymenoptera-venom anaphylaxis. Retrospective review of a systemic mastocytosis cohort was performed to assess fire ant-venom anaphylaxis rate and treatment patterns.
RESULTS
Fire ant immunotherapy was the most frequently ordered individual immunotherapy prescription 45.9% ( = 878). Fire ant prescriptions surpassed all flying Hymenoptera immunotherapy prescriptions combined in six states. Fire ant and flying Hymenoptera-venom anaphylaxis prevalence in the general population was 0.048% and 0.083%, respectively. Fire ant-venom anaphylaxis prevalence in the 14 colonized states was 0.085%. More patients with systemic mastocytosis had anaphylaxis triggered by fire ant than all flying Hymenoptera combined.
CONCLUSION
Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis is higher than all flying Hymenoptera-venom anaphylaxis combined in colonized states. Fire ant-venom anaphylaxis in systemic mastocytosis is frequently misdiagnosed and not treated with epinephrine.
背景
膜翅目昆虫螫刺可诱发致命性过敏反应，尤其是在系统性肥大细胞增多症患者中。来自南美的火蚁最近已在三大洲定居。普通人群和系统性肥大细胞增多症患者中火蚁毒液过敏反应的患病率尚不清楚。目的是确定特里卡医疗保险受益人以及系统性肥大细胞增多症患者中火蚁毒液过敏反应的患病率。
方法
我们查询了接受膜翅目昆虫毒液或火蚁全身提取物免疫治疗患者的受益人免疫治疗处方数据库，以及患有膜翅目昆虫毒液过敏（HVA）ICD - 10编码患者的特里卡医疗保险受益人人群健康登记数据库。超过95%的受益人是居住在美国的患者。对与HVA ICD - 10编码相关的150名患者的随机样本进行病历审查，以确定膜翅目昆虫毒液过敏反应患者的百分比。对系统性肥大细胞增多症队列进行回顾性审查，以评估火蚁毒液过敏反应率和治疗模式。
结果
火蚁免疫治疗是最常开具的个体免疫治疗处方，占45.9%（n = 878）。在六个州，火蚁处方超过了所有飞行膜翅目昆虫免疫治疗处方的总和。普通人群中火蚁和飞行膜翅目昆虫毒液过敏反应的患病率分别为0.048%和0.083%。在14个已定居的州，火蚁毒液过敏反应的患病率为0.085%。与所有飞行膜翅目昆虫相比，更多系统性肥大细胞增多症患者的过敏反应是由火蚁引发的。
结论
在已定居的州，普通人群和系统性肥大细胞增多症患者中火蚁毒液过敏反应的患病率高于所有飞行膜翅目昆虫毒液过敏反应患病率之和。系统性肥大细胞增多症患者的火蚁毒液过敏反应常被误诊，且未用肾上腺素治疗。
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