10/1/2012
I have a patient with allergy to venomous insect stings. She is wondering if she is at risk for anaphylaxis if she goes swimming in the ocean and is stung by jellyfish. I couldn't find much on clinically relevant cross-reactions between the venoms. Any information you can provide would be appreciated. Thank you.

Thank you for your inquiry, and for the clarification that your patient has an allergy to “honeybee”.

Unfortunately, I am not going to be able to give you a definitive answer because to the best of my knowledge, there are very little data from which we can draw any sound conclusion in answer to your inquiry.

We do know that jellyfish venom is extremely complex and may contain as many as 250 ingredients, and that these may differ to some extent between various species. Thus, it is theoretically possible that your patient may react to venom from one but not another species. However, we also know that there is no evidence to date that there has been clinical cross-reactivity. That is, so far, there has been no documented, to my knowledge, clinical instances of cross-reactivity between these two classes of venoms.

However phospholipase A2 is found in both honeybee and jellyfish venom, and that there is some homology between the phospholipase A2 in both venoms.

In summary, the weight of evidence tends to point against there being any clinical cross-reactivity, but we simply, at least to my knowledge, do not have enough data to give you a firm opinion in this regard.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.