Venom immunotherapy and difficulties encountered before and during immunotherapy: Double sensitization, systemic reactions, treatment with omalizumab, and high dose VIT

Authors

GÜLDEN PAÇACI ÇETİN
İNSU YILMAZ
MURAT TÜRK
BAHAR ARSLAN
SAKİNE NAZİK BAHÇECİOĞLU

DOI

10.55730/1300-0144.5427

Abstract

Background/aim: Venom immunotherapy (VIT) is the most effective treatment method to prevent recurrent systemic reactions to Hymenoptera stings. In this study, the demographic characteristics of VIT patients, the success rates of VIT, the difficulties we encountered during VIT, and solutions for these difficulties in our clinic were presented. Materials and methods: We retrospectively analyzed patients with venom allergy who applied venom immunotherapy between 2013- 2020. Data on age, gender, Hymenoptera species with the first reaction, grade of the reaction, beekeeping history, skin prick and specific IgE and component results, double sensitization, blood groups, and reactions with VIT and/or sting during built-up and maintenance periods were recorded. Results: A total of 73 patients were enrolled in the study. The median time from the first sting reaction to the application to the allergy outpatient clinic was 12 (0.5-24) months. The first sting reaction of 38 (52.1%) of the patients was with honey bees, and 24 (32.9%) were with wasps. Double positivity was present in 29 (40%) of the patients in prick results and 26 (36%) serologically. There was no correlation between the severity of first reactions and Apis Mellifera or Vespula prick diameters (p = 0.643; r = -0.056; p = 0.462; r = 0.089, respectively). High-dose VIT was administered to 4 patients. Omalizumab has been used as an alternative agent to achieve the maintenance dose in 2 patients with frequent systemic reactions during VIT. Conclusion: Most patients were able to tolerate VIT. Double positivity is one of the most common difficulties before VIT. In patients who develop systemic reactions in the VIT maintenance phase, a maintenance dose increase should be considered in the maintenance phase. Adding omalizumab does not seem to be a permanent solution in patients who develop a severe systemic reaction.

Keywords

Allergy, venom immunotherapy, Apis Mellifera, Vespula, double sensitization, omalizumab

First Page

1223

Last Page

1234

Recommended Citation

ÇETİN, GÜLDEN PAÇACI; YILMAZ, İNSU; TÜRK, MURAT; ARSLAN, BAHAR; and BAHÇECİOĞLU, SAKİNE NAZİK (2022) "Venom immunotherapy and difficulties encountered before and during immunotherapy: Double sensitization, systemic reactions, treatment with omalizumab, and high dose VIT," Turkish Journal of Medical Sciences: Vol. 52: No. 4, Article 42. https://doi.org/10.55730/1300-0144.5427
Available at: https://journals.tubitak.gov.tr/medical/vol52/iss4/42