If the only venom associated anaphylaxis the patient has experienced was from a wasp, and she has not had any other stings, then low grade positive IgE RAST results for all venoms after five years of venom immunotherapy probably represent clinically insignificant cross-reactivity between the venoms. If she has not had anaphylaxis from another field sting since starting her wasp venom immunotherapy, then repeat testing provides no clinically useful information. If her baseline tryptase is normal, then further venom immunotherapy appears not to be indicated at this time.
I hope this is helpful.
Eric Macy, MD, MS, FAAAAI