Clinical & Experimental Allergy

Anaphylactic reactions to Hymenoptera stings in asthmatic patients*

Authors

  • G. A. SETTIPANE,

    Corresponding author
    1. Program in Medicine, Brown University and the Division of Allergy, Departments of Medicine and Pediatrics, Rhode Island Hospital, Providence, Rhode Island, U.S.A.
      Dr Guy A. Settipane, 95 Pitman Street, Providence, Rhode Island 02906, U.S.A.
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  • F. H. CHAFEE,

    1. Program in Medicine, Brown University and the Division of Allergy, Departments of Medicine and Pediatrics, Rhode Island Hospital, Providence, Rhode Island, U.S.A.
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  • D. E. KLEIN,

    1. Program in Medicine, Brown University and the Division of Allergy, Departments of Medicine and Pediatrics, Rhode Island Hospital, Providence, Rhode Island, U.S.A.
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  • G. K. BOYD,

    1. Program in Medicine, Brown University and the Division of Allergy, Departments of Medicine and Pediatrics, Rhode Island Hospital, Providence, Rhode Island, U.S.A.
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  • J. H. STURAM,

    1. Program in Medicine, Brown University and the Division of Allergy, Departments of Medicine and Pediatrics, Rhode Island Hospital, Providence, Rhode Island, U.S.A.
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  • H. B. FREYE

    1. Program in Medicine, Brown University and the Division of Allergy, Departments of Medicine and Pediatrics, Rhode Island Hospital, Providence, Rhode Island, U.S.A.
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  • *

    Presented in part at the 35th Annual Meeting of the American Academy of Allergy, 27 March 1979, New Orleans, Louisiana.

Dr Guy A. Settipane, 95 Pitman Street, Providence, Rhode Island 02906, U.S.A.

Summary

We evaluated 587 cases with generalized reactions to stings of Hymenoptera. Eighty of these patients and twenty-eight normal controls had radioallergosorbent tests (RAST) to venoms of honey bee, yellow jacket, hornet, wasp and to phospholipase A. Those patients with systemic reactions had a significantly greater frequency of positive RAST than normal controls (51.3%vs. 7.1%, P < 0.001). The frequency of atopy (asthma/rhinitis) in these 587 cases was only 22% and resembled the expected frequency in a general population. Asthmatic patients did not have an increased risk of developing systemic reactions to Hymenoptera stings. However, those asthmatic patients with systemic reactions to Hymenoptera stings had a significantly more severe anaphylactic reaction to a sting than non-asthmatics. These severe reactions were primarily manifested by acute dyspnoea, which appeared to represent a bronchospastic response to endogenous histamine release.

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