Outcomes of Allergy to Insect Stings in Children, with and without Venom Immunotherapy

• Published in: The New England journal of medicine Vol. 351; no. 7; pp. 668 - 674
• Main Authors: Golden, David B.K, Kagey-Sobotka, Anne, Norman, Philip S, Hamilton, Robert G, Lichtenstein, Lawrence M
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 12-08-2004
• Subjects: Allergies; Animals; Bee Venoms - adverse effects; Bee Venoms - immunology; Child; Children & youth; Data Collection; Desensitization, Immunologic; Follow-Up Studies; Humans; Hymenoptera; Hypersensitivity, Immediate - classification; Hypersensitivity, Immediate - prevention & control; Immune system; Incidence; Insect bites; Insect Bites and Stings - immunology; Insecta; Medical treatment; Recurrence; Severity of Illness Index; Therapy
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa022952

About 1 out of 100 children who are stung by an insect from the order Hymenoptera has a systemic allergic reaction. Although it has been suggested that children may outgrow these reactions, there are few data on this subject. These investigators provide descriptive follow-up data on a large group of children with systemic allergic reactions to an insect sting, including children treated with venom immunotherapy. Although many children outgrew the allergy, many did not. Some protection due to immunotherapy was apparent 10 to 20 years later.
Although many children outgrew the allergy, many did not. Some protection from immunotherapy was apparent 10 to 20 years later.
Most children receive stings by hymenopterans during the years of outdoor play. A history of systemic allergic reaction appears in the medical records of at least 0.8 percent of children, but the true prevalence among the pediatric population is likely to be higher and fatal reactions have been reported.
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,
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In 1974, we reported the use of purified-venom immunotherapy in the treatment of a child
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; four years later, a controlled trial of venom immunotherapy was reported.
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The unique features of allergy to insect stings in children led to our 1990 report showing that the majority of affected children have . . .