Diagnostic outcomes and temporal changes in skin tests and specific immunoglobulin E levels following Hymenoptera sting reactions: single-center analysis of 194 patients

Abstract

Hymenoptera stings are a common occurrence worldwide, with a significant proportion of the general population experiencing at least one sting during their lifetime. The order Hymenoptera includes several species, such as honey bees, hornets, bumblebees, and yellow jackets, that cause hypersensitivity reactions. The most common form of hypersensitivity is systemic sting reaction mediated by specific immunoglobulin E (sIgE) to venom components. The prevalence of systemic sting reaction in the general population is estimated to be approximately 3%, while gross local reactions are reported in 2.4–26.4% of individuals, with higher proportions in beekeepers. Identification of the offender insect is crucial for proper diagnosis and treatment, but many patients are unable to correctly distinguish the responsible venom. Standard diagnostic tools, such as intradermal testing and Hymenoptera venom sIgE tests, play an important role in determining venom sensitivity. However, cross-reactivity between different venoms makes accurate identification difficult. In this study, we aim to analyze the clinical history of patients with Hymenoptera venom hypersensitivity and evaluate the diagnostic approach. Understanding these factors is important to improve diagnostic accuracy and optimize patient management. Further research is needed to improve diagnostic tools and develop personalized treatment strategies to reduce the risk of severe allergic reactions in susceptible individuals. Our study suggests that diagnostic tests should be performed rapidly in reactions that develop after an Apis sting, especially due to the significant decrease in Apis sIgE levels.