Quoi de neuf dans l'allergie aux venins d’hyménoptères ? Une revue critique de la littérature récente (fin 2000–début 2001)

Abstract

Several recent articles draw our attention to important aspects of hymenoptera venom allergy. A new bee venom allergen (Api m 6) that elicits a strong IgE and T-cell response in a large number of bee venom-allergic patients has been identified and sequenced. A high rate of relapse is reported in patients with severe anaphylactic reactions, but showing negative skin tests responses: hyposensitization is recommended when those patients have detectable levels of specific IgE. If the results of specific IgE determinations are also negative, it is prudent to recommend epinephrine availability. Ultra-rush venom immunotherapy and prolongation up to 3 months of the interval between maintenance injections may be safe and efficient; however, we need more information before the generalization of these procedures. Finally, the duration of venom immunotherapy must be discussed on the basis of the severity of the initial reaction, but also on the basis of other risk factors of relapse such as age of the patients, underlying cardiovascular and cardiopulmonary diseases, antihypertensive treatments, etc., in order to reduce the risk of severe relapse after discontinuation of treatment.