Q:

11/13/2013
I saw a 17 year old man for urticaria following a stinging insect sting. He had positive testing to yellow jacket and hornet. He plans to study environmental management and will be outside almost daily during the spring and summer and fall. I think he needs to be treated with venom specific immunotherapy. What is your opinion?

A:

Thank you for your inquiry.

I agree with you that the patient described is a candidate for immunotherapy and would personally treat him with venom immunotherapy. This is in keeping with the recommendations of the most recent Parameters regarding hymenoptera sensitivity (see quote below) (1).

“… venom immunotherapy is generally recommended for patients older than 16 years with systemic reactions limited to the skin.”

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

Reference:
Golden DBK, et al. Stinging insect hypersensitivity: a practice parameter update 2011. J Allergy Clin Immunol 2011; 127(4):852-854.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology