Indications de la désensibilisation en fonction des données épidémiologiques récentes

Abstract

In most cases, hymenoptera venom allergy is caused by bees or wasps, but also occasionally by hornets, bumblebees or other members of the Vespidae family. The prevalence of sensitisation to venom in adults who have not had an allergic reaction following an insect sting but who have a positive skin test and/or specific IgE is estimated to be between 9.3% and 28.7%. The prevalence of systemic reactions in the general population reported in the literature ranges from 0.15% to 3.3%. The risk of having another systemic reaction following a subsequent sting depends on a number of factors: (1) the severity of the preceding reaction, (2) age, (3) the responsible insect, (4) occupation, (5) interval since the previous reaction. The risk of having a particularly severe reaction also depends on several other factors: the presence of cardiovascular disease, treatment with a beta-blocker, an elevated serum tryptase, and the presence of mastocytosis. The indications for venom immunotherapy in patients with positive skin and/or blood tests must take include consideration of the risk factors for a severe reaction with a new sting.