Aim: To make the treatment approach in patients suffering a European hornet sting allergy reaction more personalized, preparing them also for possible future risks.
Methods: In Slovenia an extended retrospective observational cohort epidemiological study about the natural history of Hymenoptera venom sensitivity is in progress. The study is based on data from the healthcare records of the University Clinic Golnik (UCG) and data collected by a questionnaire sent to patients from May 2019 to April 2021. For a pilot study, we selected patients who were referred to UCG because of an allergic reaction to European hornet sting and had been re-stung later by a wasp (n=68). The association between severe systemic allergic reactions (SSAR) after wasp sting and potential risk factors in subjects with a history of hornet sting allergy was assessed univariately using the likelihood ratio test.
Results: Among 68 European hornet allergic patients 27 reacted with an SSAR and 41 reacted with a mild SAR. Among 27 patients with SSAR, 4 reacted with an SSAR also to a subsequent wasp sting. Among 41 patients with a mild European hornet sting SAR nobody reacted with an SSAR to a subsequent wasp sting. The association between the severity of the wasp SAR reaction in European hornet allergic patients was statistically significant (p=0.022).
Conclusion: Our results suggest that patients with severe European hornet SAR should be considered for wasp venom immunotherapy or prophylactic prescription of epinephrine auto-injector as they are at risk for an SSAR also after wasp string.
Namen: Prilagoditi vodenje in zdravljenje bolnikov z alergijsko reakcijo po piku evropskega sršena in jih podučiti o morebitnih tveganjih ob naslednjem piku kožekrilca.
Metode: Na Univerzitetni kliniki za pljučne bolezni in alergijo, Golnik (UKG), Slovenija se izvaja obsežna opazovalna kohortna epidemiološka raziskava o naravnem poteku alergije po piku žuželk iz rodu Hymenoptera, ki temelji na podatkih iz podatkovne baze UKG in podatkov pridobljenih iz vprašalnika, ki se je pošiljal bolnikom od maja 2019 do aprila 2021. V pilotno študijo smo vključili tiste bolnike, ki so reagirali z alergijsko reakcijo po piku Evropskega sršena in jih je kasneje pičila osa (n = 68). Za oceno povezanosti med opazovanci s težko sistemsko alergijsko reakcijo (SSAR) po piku ose pri opazovancih z alergijsko reakcijo po piku evropskega sršena v anamnezi in potencialmi dejavniki tveganja smo uporabili univariatno statistično metodo.
Rezultati: 68 bolnikov je imelo alergijsko reakcijo po piku evropskega sršena. 27 jih je reagiralo s težko SAR in 41 z blago. Med 27 bolniki s težko SAR po piku sršena, so 4 bolniki reagirali s težko SAR po kasnejšem piku ose. Med 41 bolniki, ki so po prvem piku Evropskega sršena reagirali z blago SAR, nihče ni reagiral s težko SAR po kasnejšem piku ose. Rezultati so pokazali močno povezanost med težko SAR po piku evropskega sršena in težavnostjo SAR po ponovnih pikih ose (p = 0,022).
Zaključki: Vodenje in zdravljenje bolnikov s težko SAR po piku Evropskega sršena naj vključuje imunoterapijo s strupom ose ali profilaktično nošenje avtoinjektorja z epinefrinom za samopomoč, kar je izjemnega pomena zaradi življenje ogrožajoče nevarnosti ob morebitnem piku ose.
Keywords: European hornet sting; Healthcare; Hymenoptera allergy; Public health; Severe systemic allergic reactions; Wasp sting.
© 2024 Simona Perčič et al., published by Sciendo.