Skip to main content
SpringerLink
Log in

Insect Sting Allergy and Mast Cell Disease

  • Chapter
  • First Online:
Stinging Insect Allergy

  • 568 Accesses

Abstract

Up to 5% of adult patients with Hymenoptera venom allergy (HVA) may simultaneously suffer from a clonal mast cell disease. Usually, a mastocytosis or a monoclonal mast cell activation syndrome is not diagnosed before the appearance of a sting anaphylaxis. The majority of patients with a clonal mast cell disease and HVA will not present with significant symptoms except osteoporosis and symptoms of mast cell release due to other triggers. The diagnosis of a mast cell disease will lead to several therapeutic consequences concerning the treatment of HVA. Therefore, it is recommended to screen all adults with systemic sting reactions for an increased baseline tryptase concentration (BTC, >11.4 μg/l) and mastocytosis in the skin (MIS). Patients with MIS, a significantly increased BTC (>20 μg/l), and/or a history of a severe anaphylactic sting reaction (i.e., anaphylactic shock or near-fatal reactions) require further examination. If MIS is absent or if it is necessary to identify the exact type of clonal mast cell disease, patient work-up should include a liquid biopsy (i.e., screening for a KIT D816V mutation in the peripheral blood) and a bone marrow biopsy. Venom immunotherapy (VIT) is urgently recommended for patients with a clonal mast cell disease and should include an increased maintenance dose right from the beginning in patients with a honeybee venom allergy or with a history of near-fatal sting reactions. Patients with a clonal mast cell disease are at an increased risk for treatment failure; therefore, we suggest to perform sting challenge tests in order to document the efficacy of VIT. VIT should be continued lifelong.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

BM:

Bone marrow

CM:

Cutaneous mastocytosis

HVA:

Hymenoptera venom allergy

ISM:

Indolent systemic mastocytosis

MC:

Mast cells

MIS:

Mastocytosis in the skin

MMAS:

Monoclonal mast cell activation syndrome

SM:

Systemic mastocytosis

VIT:

Venom immunotherapy

References

  1. Sotlar K, Horny HP, Simonitsch I, Krokowski M, Aichberger KJ, Mayerhofer M, Printz D, Fritsch G, Valent P. CD25 indicates the neoplastic phenotype of mast cells: a novel immunohistochemical marker for the diagnosis of systemic mastocytosis (SM) in routinely processed bone marrow biopsy specimens. Am J Surg Pathol. 2004;28:1319–25.

    Article  PubMed  Google Scholar 

  2. Pardanani A, Kimlinger TK, Reeder TL, Li CY, Tefferi A. Differential expression of CD2 on neoplastic mast cells in patients with systemic mast cell disease with and without an associated clonal haematological disorder. Br J Haematol. 2003;120:691–4.

    Article  CAS  PubMed  Google Scholar 

  3. Alvarez-Twose I, González de Olano D, Sánchez-Muñoz L, Matito A, Esteban-López MI, Vega A, Mateo MB, Alonso Díaz de Durana MD, de la Hoz B, Del Pozo Gil MD, Caballero T, Rosado A, Sánchez Matas I, Teodósio C, Jara-Acevedo M, Mollejo M, García-Montero A, Orfao A, Escribano L. Clinical, biological and molecular characteristics of systemic mast cell disorders presenting with severe mediator-related symptoms. J Allergy Clin Immunol. 2010;125:1269–78.

    Article  CAS  PubMed  Google Scholar 

  4. Bonadonna P, Bonifacio M, Lombardo C, Zanotti R. Hymenoptera allergy and mast cell activation syndromes. Curr Allergy Asthma Rep. 2016;16:5. doi:10.1007/s11882-015-0582-5.

    Article  PubMed  Google Scholar 

  5. Garcia-Montero AC, Jara-Acevedo M, Teodosio C, Sanchez ML, Nunez R, Prados A, Aldanondo I, Sanchez L, Dominguez M, Botana LM, Sanchez-Jimenez F, Sotlar K, Almeida J, Escribano L, Orfao A. KIT mutation in mast cells and other bone marrow hematopoietic cell lineages in systemic mast cell disorders: a prospective study of the Spanish Network on Mastocytosis [REMA] in a series of 113 patients. Blood. 2006;108:2366–72.

    Article  CAS  PubMed  Google Scholar 

  6. Orfao A, Garcia-Montero AC, Sanchez L, Escribano L. Recent advances in the understanding of mastocytosis: the role of KIT mutations. Br J Haematol. 2007;138:12–30.

    Article  CAS  PubMed  Google Scholar 

  7. Longley BJ, Reguera MJ, Ma Y. Classes of c-KIT activating mutations: proposed mechanisms of action and implications for disease classification and therapy. Leuk Res. 2001;25:571–6.

    Article  CAS  PubMed  Google Scholar 

  8. Horny HP, Metcalfe DD, Bennett JM, Bain BJ, Akin C, Escribano L, et al. Mastocytosis. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO classification of tumors of hematopoietic and lymphoid tissues. 4th ed. Lyon: IARC Press; 2008. p. 54–63.

    Google Scholar 

  9. Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, Bloomfield CD, Cazzola M, Vardiman JW. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127:2391–405.

    Article  CAS  PubMed  Google Scholar 

  10. Núñez-López R, Escribano L, Schernthaner GH, Prados A, Rodríguez-González R, Díaz-Agustín B, López A, Hauswirth A, Valent P, Almeida J, Bravo P, Orfao A. Overexpression of complement receptors and related antigens on the surface of bone marrow mast cells in patients with systemic mastocytosis. Br J Haematol. 2003;120:257–65.

    Article  PubMed  Google Scholar 

  11. Sonneck K, Florian S, Müllauer L, Wimazal F, Födinger M, Sperr WR, Valent P. Diagnostic and subdiagnostic accumulation of mast cells in the bone marrow of patients with anaphylaxis: monoclonal mast cell activation syndrome. Int Arch Allergy Immunol. 2006;142:158–64.

    Article  PubMed  Google Scholar 

  12. Akin C, Scott LM, Kocabas CN, Kushnir-Sukhov N, Brittain E, Noel P, Metcalfe DD. Demonstration of an aberrant mast cell population with clonal markers in a subset of patients with “idiopathic” anaphylaxis. Blood. 2007;110:2331–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Bonadonna P, Perbellini O, Passalacqua G, Caruso B, Colarossi S, Dal Fior D, et al. Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels. J Allergy Clin Immunol. 2009;123:680–6.

    Article  CAS  PubMed  Google Scholar 

  14. Valent P, Akin C, Arock M, Brockow K, Butterfield JH, Carter MC, Castells M, Escribano L, Hartmann K, Lieberman P, Nedoszytko B, Orfao A, Schwartz LB, Sotlar K, Sperr WR, Triggiani M, Valenta R, Horny HP, Metcalfe DD. Definitions, criteria and global classification of mast cell disorders with special reference to mast cell activation syndromes: a consensus proposal. Int Arch Allergy Immunol. 2012;157:215–25.

    Article  PubMed  Google Scholar 

  15. Gülen T, Hägglund H, Sander B, Dahlén B, Nilsson G. The presence of mast cell clonality in patients with unexplained anaphylaxis. Clin Exp Allergy. 2014;44:1179–87.

    Article  PubMed  Google Scholar 

  16. Valent P. Mast cell activation syndromes: definition and classification. Allergy. 2013;68:417–24.

    Article  CAS  PubMed  Google Scholar 

  17. Alvarez-Twose I, Zanotti R, González-de-Olano D, Bonadonna P, Vega A, Matito A, Sánchez-Muñoz L, Morgado JM, Perbellini O, García-Montero A, De Matteis G, Teodósio C, Rossini M, Jara-Acevedo M, Schena D, Mayado A, Zamò A, Mollejo M, Sánchez-López P, Cabañes N, Orfao A, Escribano L, Spanish Network on Mastocytosis (REMA), Italian Network on Mastocytosis (RIMA). Nonaggressive systemic mastocytosis [SM] without skin lesions associated with insect-induced anaphylaxis shows unique features versus other indolent SM. J Allergy Clin Immunol. 2014;133:520–8.

    Article  PubMed  Google Scholar 

  18. Schwartz LB. Diagnostic value of tryptase in anaphylaxis and mastocytosis. Immunol Allergy Clin North Am. 2006;26:451–63.

    Article  PubMed  Google Scholar 

  19. Escribano L, Alvarez-Twose I, Sánchez-Muñoz L, Garcia-Montero A, Núñez R, Almeida J, Jara-Acevedo M, Teodósio C, García-Cosío M, Bellas C, Orfao A. Prognosis in adult indolent systemic mastocytosis: a long-term study of the Spanish Network on Mastocytosis in a series of 145 patients. J Allergy Clin Immunol. 2009;124:514–21.

    Article  PubMed  Google Scholar 

  20. Rossini M, Zanotti R, Bonadonna P, Artuso A, Caruso B, Schena D, Vecchiato D, Bonifacio M, Viapiana O, Gatti D, Senna G, Riccio A, Passalacqua G, Pizzolo G, Adami S. Bone mineral density, bone turnover markers and fractures in patients with indolent systemic mastocytosis. Bone. 2011;49:880–5.

    Article  PubMed  Google Scholar 

  21. Valent P, Akin C, Escribano L, Födinger M, Hartmann K, Brockow K, Castells M, Sperr WR, Kluin-Nelemans HC, Hamdy NA, Lortholary O, Robyn J, van Doormaal J, Sotlar K, Hauswirth AW, Arock M, Hermine O, Hellmann A, Triggiani M, Niedoszytko M, Schwartz LB, Orfao A, Horny HP, Metcalfe DD. Standards and standardization in mastocytosis: consensus statements on diagnostics, treatment recommendations and response criteria. Eur J Clin Invest. 2007;37:435–53.

    Article  CAS  PubMed  Google Scholar 

  22. Berezowska S, Flaig MJ, Ruëff F, Walz C, Haferlach T, Krokowski M, Kerler R, Petat-Dutter K, Horny HP, Sotlar K. Adult-onset mastocytosis in the skin is highly suggestive of systemic mastocytosis. Mod Pathol. 2014;27:19–29.

    Article  CAS  PubMed  Google Scholar 

  23. Zanotti R, Lombardo C, Passalacqua G, Caimmi C, Bonifacio M, De Matteis G, Perbellini O, Rossini M, Schena D, Busa M, Marcotulli MC, Bilò MB, Franchini M, Marchi G, Simioni L, Bonadonna P. Clonal mast cell disorders in patients with severe Hymenoptera venom allergy and normal serum tryptase levels. J Allergy Clin Immunol. 2015;136:135–9.

    Article  CAS  PubMed  Google Scholar 

  24. Kristensen T, Vestergaard H, Bindslev-Jensen C, Møller MB, Broesby-Olsen S, Mastocytosis Centre, Odense University Hospital [MastOUH]. Sensitive KIT D816V mutation analysis of blood as a diagnostic test in mastocytosis. Am J Hematol. 2014;89:493–8.

    Article  CAS  PubMed  Google Scholar 

  25. Erben P, Schwaab J, Metzgeroth G, Horny HP, Jawhar M, Sotlar K, Fabarius A, Teichmann M, Schneider S, Ernst T, Müller MC, Giehl M, Marx A, Hartmann K, Hochhaus A, Hofmann WK, Cross NC, Reiter A. The KIT D816V expressed allele burden for diagnosis and disease monitoring of systemic mastocytosis. Ann Hematol. 2014;93:81–8.

    Article  CAS  PubMed  Google Scholar 

  26. De Matteis G, Zanotti R, Colarossi S, De Benedittis C, Garcia-Montero A, Bonifacio M, Sartori M, Aprili F, Caruso B, Paviati E, Carli G, Perbellini O, Zamò A, Bonadonna P, Pizzolo G, Guidi G, Martinelli G, Soverini S. The impact of sensitive KIT D816V detection on recognition of indolent systemic mastocytosis. Leuk Res. 2015;39:273–8.

    Article  PubMed  Google Scholar 

  27. Jara-Acevedo M, Teodosio C, Sanchez-Muñoz L, Álvarez-Twose I, Mayado A, Caldas C, Matito A, Morgado JM, Muñoz-González JI, Escribano L, Garcia-Montero AC, Orfao A. Detection of the KIT D816V mutation in peripheral blood of systemic mastocytosis: diagnostic implications. Mod Pathol. 2015;28:1138–49.

    Article  CAS  PubMed  Google Scholar 

  28. Valent P, Escribano L, Broesby-Olsen S, Hartmann K, Grattan C, Brockow K, Niedoszytko M, Nedoszytko B, Oude Elberink JN, Kristensen T, Butterfield JH, Triggiani M, Alvarez-Twose I, Reiter A, Sperr WR, Sotlar K, Yavuz S, Kluin-Nelemans HC, Hermine O, Radia D, van Doormaal JJ, Gotlib J, Orfao A, Siebenhaar F, Schwartz LB, Castells M, Maurer M, Horny HP, Akin C, Metcalfe DD, Arock M, European Competence Network on Mastocytosis. Proposed diagnostic algorithm for patients with suspected mastocytosis: a proposal of the European Competence Network on Mastocytosis. Allergy. 2014;69:1267–74.

    Article  CAS  PubMed  Google Scholar 

  29. Arock M, Sotlar K, Akin C, Broesby-Olsen S, Hoermann G, Escribano L, Kristensen TK, Kluin-Nelemans HC, Hermine O, Dubreuil P, Sperr WR, Hartmann K, Gotlib J, Cross NC, Haferlach T, Garcia-Montero A, Orfao A, Schwaab J, Triggiani M, Horny HP, Metcalfe DD, Reiter A, Valent P. KIT mutation analysis in mast cell neoplasms: recommendations of the European Competence Network on Mastocytosis. Leukemia. 2015;29:1223–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Perbellini O, Zamò A, Colarossi S, Zampieri F, Zoppi F, Bonadonna P, Schena D, Artuso A, Martinelli G, Chilosi M, Pizzolo G, Zanotti R. Primary role of multiparametric flow cytometry in the diagnostic work-up of indolent clonal mast cell disorders. Cytometry B Clin Cytom. 2011;80:362–8.

    Article  PubMed  Google Scholar 

  31. Sánchez-Muñoz L, Alvarez-Twose I, García-Montero AC, Teodosio C, Jara-Acevedo M, Pedreira CE, Matito A, Morgado JM, Sánchez ML, Mollejo M, Gonzalez-de-Olano D, Orfao A, Escribano L. Evaluation of the WHO criteria for the classification of patients with mastocytosis. Mod Pathol. 2011;24:1157–68.

    Article  PubMed  Google Scholar 

  32. Sperr WR, Escribano L, Jordan JH, Schernthaner GH, Kundi M, Horny HP, Valent P. Morphologic properties of neoplastic mast cells: delineation of stages of maturation and implication for cytological grading of mastocytosis. Leuk Res. 2001;25:529–36.

    Article  CAS  PubMed  Google Scholar 

  33. Escribano L, Diaz-Agustin B, López A, Núñez López R, García-Montero A, Almeida J, Prados A, Angulo M, Herrero S, Orfao A, Spanish Network on Mastocytosis (REMA). Immunophenotypic analysis of mast cells in mastocytosis: When and how to do it. Proposals of the Spanish Network on Mastocytosis [REMA]. Cytometry Part B. 2004;58B:1–8.

    Article  Google Scholar 

  34. Brockow K. Epidemiology, prognosis, and risk factors in mastocytosis. Immunol Allergy Clin North Am. 2014;34:283–95.

    Article  PubMed  Google Scholar 

  35. Zanotti R, Simioni L, Garcia-Montero AC, Perbellini O, Bonadonna P, Caruso B, Jara-Acevedo M, Bonifacio M, De Matteis G. Somatic D816V KIT mutation in a case of adult-onset familial mastocytosis. J Allergy Clin Immunol. 2013;131:605–7.

    Article  CAS  PubMed  Google Scholar 

  36. Rabenhorst A, Leja S, Schwaab J, Gehring M, Förster A, Arock M, Reiter A, Raap U, Hartmann K. Expression of programmed cell death ligand-1 in mastocytosis correlates with disease severity. J Allergy Clin Immunol. 2016;137:314–8.

    Article  CAS  PubMed  Google Scholar 

  37. van Doormaal JJ, Arends S, Brunekreeft KL, van der Wal VB, Sietsma J, van Voorst Vader PC, Oude Elberink JN, Kluin-Nelemans JC, van der Veer E, de Monchy JG. Prevalence of indolent systemic mastocytosis in a Dutch region. J Allergy Clin Immunol. 2013;131:1429–31.

    Article  PubMed  Google Scholar 

  38. Cohen SS, Skovbo S, Vestergaard H, Kristensen T, Møller M, Bindslev-Jensen C, Fryzek JP, Broesby-Olsen S. Epidemiology of systemic mastocytosis in Denmark. Br J Haematol. 2014;166:521–8.

    Article  PubMed  Google Scholar 

  39. Ruëff F, Vos B, Oude Elberink J, Bender A, Chatelain R, Dugas-Breit S, Horny HP, Küchenhoff H, Linhardt A, Mastnik S, Sotlar K, Stretz E, Vollrath R, Przybilla B, Flaig M. Predictors of clinical effectiveness of Hymenoptera venom immunotherapy. Clin Exp Allergy. 2014;44:736–46.

    Article  PubMed  Google Scholar 

  40. Brockow K, Jofer C, Behrendt H, Ring J. Anaphylaxis in patients with mastocytosis: a study on history, clinical features and risk factors in 120 patients. Allergy. 2008;63:226–32.

    Article  CAS  PubMed  Google Scholar 

  41. Gonzalez de Olano D, de la Hoz CB, Nunez Lopez R, Sánchez Muñoz L, Cuevas Agustín M, Diéguez MC, Alvarez Twose I, Castells MC, Escribano Mora L. Prevalence of allergy and anaphylactic symptoms in 210 adult and ediatric patients with mastocytosis in Spain: a study of the Spanish Network on Mastocytosis (REMA). Clin Exp Allergy. 2007;37:1547–55.

    CAS  PubMed  Google Scholar 

  42. Rossini M, Zanotti R, Orsolini G, Tripi G, Viapiana O, Idolazzi L, Zamò A, Bonadonna P, Kunnathully V, Adami S, Gatti D. Prevalence, pathogenesis, and treatment options for mastocytosis-related osteoporosis. Osteoporos Int. 2016;27(8):2411–21. [Epub ahead of print]

    Article  CAS  PubMed  Google Scholar 

  43. Müller UR, Horat W, Wüthrich B, Conroy M, Reisman RE. Anaphylaxis after Hymenoptera stings in three patients with urticaria pigmentosa. J Allergy Clin Immunol. 1983;72:685–9.

    Article  PubMed  Google Scholar 

  44. Oude Elberink JNK, de Moncky JGR, Kors JW, van Doormaal JJ, Dubois AE. Fatal anaphylaxis after a yellow jacket sting, despite venom immunotherapy, in two patients with mastocytosis. J Allergy Clin Immunol. 1997;99:153–4.

    Article  CAS  PubMed  Google Scholar 

  45. Ludolph-Hauser D, Ruëff F, Fries C, Schöpf P, Przybilla B. Constitutively raised serum concentrations of mast-cell tryptase and severe anaphylactic reactions to Hymenoptera stings. Lancet. 2001;357:361–2.

    Article  CAS  PubMed  Google Scholar 

  46. Ruëff F, Placzek M, Przybilla B. Mastocytosis and Hymenoptera venom allergy. Curr Opin Allergy Clin Immunol. 2006;6:284–8.

    Article  PubMed  Google Scholar 

  47. Niedoszytko M, Bonadonna P, Oude Elberink JN, Golden DB. Epidemiology, diagnosis, and treatment of Hymenoptera venom allergy in mastocytosis patients. Immunol Allergy Clin North Am. 2014;34:365–81.

    Article  PubMed  Google Scholar 

  48. Bonadonna P, Lombardo C, Zanotti R. Mastocytosis and allergic diseases. J Investig Allergol Clin Immunol. 2014;24:288–97.

    CAS  PubMed  Google Scholar 

  49. Zanotti R, Bonadonna P, Bonifacio M, Artuso A, Schena D, Rossini M, Perbellini O, Colarossi S, Chilosi M, Pizzolo G. Isolated bone marrow mastocytosis: an underestimated subvariant of indolent systemic mastocytosis. Haematologica. 2011;96:482–4.

    Article  PubMed  Google Scholar 

  50. Jennings S, Russell N, Jennings B, Slee V, Sterling L, Castells M, Valent P, Akin C. The Mastocytosis Society survey on mast cell disorders: patient experiences and perceptions. J Allergy Clin Immunol Pract. 2014;2:70–6.

    Article  PubMed  Google Scholar 

  51. Horan RF, Austen KF. Systemic mastocytosis: retrospective review of a decade’s clinical experience at the Brigham and Women’s Hospital. J Invest Dermatol. 1991;96(Suppl 3):5–13.

    Article  Google Scholar 

  52. Florian S, Krauth MT, Simonitsch-Klupp I, Sperr WR, Fritsche-Polanz R, Sonneck K, Fodinger M, Agis H, Bohm A, Wimazal F, Horny HP, Valent P. Indolent systemic mastocytosis with elevated serum tryptase, absence of skin lesions, and recurrent severe anaphylactoid episodes. Int Arch Allergy Immunol. 2005;136:273–80.

    Article  PubMed  Google Scholar 

  53. Wimazal F, Geisser O, Shnawa P, Sperr WR, Valent P. Severe life-threating or disabling anaphylaxis in patients with systemic mastocytosis: a single-center experience. Int Arch Allergy Immunol. 2011;157:399–405.

    Article  PubMed  Google Scholar 

  54. van Anrooij B, van der Veer E, de Monchy JG, van der Heide S, Kluin-Nelemans JC, van Voorst Vader PC, van Doormaal JJ, Oude Elberink JN. Higher mast cell load decreases the risk of Hymenoptera venom-induced anaphylaxis in patients with mastocytosis. J Allergy Clin Immunol. 2013;132:125–30.

    Article  PubMed  Google Scholar 

  55. Castells MC, Hornick JL, Akin C. Anaphylaxis after hymenoptera sting: is it venom allergy, a clonal disorder, or both? J Allergy Clin Immunol Pract. 2015;3:350–5.

    Article  PubMed  Google Scholar 

  56. Alvarez-Twose I, Vañó-Galván S, Sánchez-Muñoz L, Morgado JM, Matito A, Torrelo A, Jaén P, Schwartz LB, Orfao A, Escribano L. Increased serum baseline tryptase levels and extensive skin involvement are predictors for the severity of mast cell activation episodes in children with mastocytosis. Allergy. 2012;67:813–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Maurer M, Wedemeyer J, Metz M, et al. Mast cells promote homeostasis by limiting endothelin-1-induced toxicity. Nature. 2004;432:512–6.

    Article  CAS  PubMed  Google Scholar 

  58. King TP, Jim SY, Wittkowski KM. Inflammatory role of two venom components of yellow jackets (Vespula vulgaris): a mast cell degranulating peptide mastoparan and phospholipase A1. Int Arch Allergy Immunol. 2003;131:25–32.

    Article  CAS  PubMed  Google Scholar 

  59. Souza BM, Mendes MA, Santos LD, et al. Structural and functional characterization of two novel peptide toxins isolated from the venom of the social wasp Polybia paulista. Peptides. 2005;26:2157–64.

    Article  CAS  PubMed  Google Scholar 

  60. Konno K, Hisada M, Naoki H, et al. Eumenitin, a novel antimicrobial peptide from the venom of the solitary eumenine wasp Eumenes rubronotatus. Peptides. 2006;27:2624–31.

    Article  CAS  PubMed  Google Scholar 

  61. Mendes MA, Palma MS. Two new bradykinin-related peptides from the venom of the social wasp Protopolybia exigua (Saussure). Peptides. 2006;27:2632–9.

    Article  CAS  PubMed  Google Scholar 

  62. Cerovský V, Hovorka O, Cvacka J, et al. Melectin: a novel antimicrobial peptide from the venom of the cleptoparasitic bee Melecta albifrons. ChemBioChem. 2008;9:2815–21.

    Article  PubMed  Google Scholar 

  63. Ruëff F, Dugas-Breit S, Przybilla B. Stinging Hymenoptera and mastocytosis. Curr Opin Allergy Clin Immunol. 2009;9:338–42.

    Article  PubMed  Google Scholar 

  64. Yavuz ST, Sackesen C, Sahiner UM, Buyuktiryaki B, Arik Yilmaz E, Sekerel BE, Soyer OU, Tuncer A. Importance of serum basal tryptase levels in children with insect venom allergy. Allergy. 2013;68:386–91.

    Article  CAS  PubMed  Google Scholar 

  65. Ruëff F, Przybilla B, Biló MB, Müller U, Scheipl F, Aberer W, Birnbaum J, Bodzenta-Lukaszyk A, Bonifazi F, Bucher C, Campi P, Darsow U, Egger C, Haeberli G, Hawranek T, Körner M, Kucharewicz I, Küchenhoff H, Lang R, Quercia O, Reider N, Severino M, Sticherling M, Sturm GJ, Wüthrich B. Predictors of severe systemic anaphylactic reactions in patients with Hymenoptera venom allergy: importance of baseline serum tryptase-a study of the European Academy of Allergology and Clinical Immunology Interest Group on Insect Venom Hypersensitivity. J Allergy Clin Immunol. 2009;124:1047–54.

    Article  PubMed  Google Scholar 

  66. Blum S, Gunzinger A, Müller UR, Helbling A. Influence of total and specific IgE, serum tryptase, and age on severity of allergic reactions to Hymenoptera stings. Allergy. 2011;66:222–8.

    Article  CAS  PubMed  Google Scholar 

  67. Ruëff F, Przybilla B, Biló MB, Müller U, Scheipl F, Seitz MJ, Aberer W, Bodzenta-Lukaszyk A, Bonifazi F, Campi P, Darsow U, Haeberli G, Hawranek T, Küchenhoff H, Lang R, Quercia O, Reider N, Schmid-Grendelmeier P, Severino M, Sturm GJ, Treudler R, Wüthrich B. Clinical effectiveness of hymenoptera venom immunotherapy: a prospective observational multicenter study of the European academy of allergology and clinical immunology interest group on insect venom hypersensitivity. PLoS One. 2013;8(5):e63233. doi:10.1371/journal.pone.0063233. Print 2013.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Wagner N, Fritze D, Przybilla B, Hagedorn M, Ruëff F. Fatal anaphylactic sting reaction in a patient with mastocytosis. Int Arch Allergy Immunol. 2008;146:162–3.

    Article  CAS  PubMed  Google Scholar 

  69. Ring J, Beyer K, Biedermann T, Bircher A, Duda D, Fischer J, Friedrichs F, Fuchs T, Gieler U, Jakob T, Klimek L, Lange L, Merk HF, Niggemann B, Pfaar O, Przybilla B, Ruëff F, Rietschel E, Schnadt S, Seifert R, Sitter H, Varga EM, Worm M, Brockow K. Guideline for acute therapy and management of anaphylaxis: S2 Guideline of the German Society for Allergology and Clinical Immunology (DGAKI). Allergo J Int. 2014;23:96–112.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Reimers A, Müller U. Fatal outcome of a Vespula sting in a patient with mastocytosis after specific immunotherapy with honey bee venom. Allergy Clin Immunol Int. 2005;17(Suppl 1):69–70.

    Google Scholar 

  71. Lockey RF, Turkeltaub PC, Baird-Warren IA, et al. The Hymenoptera venom study I, 1979-1982: demographics and history-sting data. J Allergy Clin Immunol. 1988;82:370–81.

    Article  CAS  PubMed  Google Scholar 

  72. Solley GO. Stinging and biting insect allergy: an Australian experience. Ann Allergy Asthma Immunol. 2004;93:532–7.

    Article  PubMed  Google Scholar 

  73. Verburg M, Oldhoff JM, Klemans RJ, Lahey-de Boer A, de Bruin-Weller MS, Röckmann H, Sanders C, Bruijnzeel-Koomen CA, Pasmans SG, Knulst AC. Rush immunotherapy for wasp venom allergy seems safe and effective in patients with mastocytosis. Eur Ann Allergy Clin Immunol. 2015;47:192–6.

    CAS  PubMed  Google Scholar 

  74. Fricker M, Helbling A, Schwartz L, Müller U. Hymenoptera sting anaphylaxis and urticaria pigmentosa: clinical findings and results of venom immunotherapy in ten patients. J Allergy Clin Immunol. 1997;100:11–5.

    Article  CAS  PubMed  Google Scholar 

  75. Bonadonna P, Gonzalez-de-Olano D, Zanotti R, Riccio A, De Ferrari L, Lombardo C, Rogkakou A, Escribano L, Alvarez-Twose I, Matito A, Vega A, Passalacqua G. Venom immunotherapy in patients with clonal mast cell disorders: efficacy, safety, and practical considerations. J Allergy Clin Immunol Pract. 2013;1:474–8.

    Article  PubMed  Google Scholar 

  76. Kors JW, Van Doormaal JJ, De Monchy JGR. Anaphylactoid shock following Hymenoptera sting as a presenting symptom of systemic mastocytosis. J Intern Med. 1993;233:255–8.

    Article  CAS  PubMed  Google Scholar 

  77. Dubois AE. Mastocytosis and Hymenoptera allergy. Curr Opin Allergy Clin Immunol. 2004;4:291–5.

    Article  PubMed  Google Scholar 

  78. Stretz E, Oppel EM, Räwer H-C, Chatelain R, Mastnik S, Przybilla B, Ruëff F. Overcoming severe adverse reactions to venom immunotherapy by using anti-IgE antibodies and high maintenance doses. Submitted

    Google Scholar 

  79. Ruëff F, Wenderoth A, Przybilla B. Patients still reacting to a sting challenge while receiving Hymenoptera venom immunotherapy are protected by increased venom doses. J Allergy Clin Immunol. 2001;108:1027–32.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Allergy Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, Verona, 36126, Italy

    Patrizia Bonadonna

  2. Section of Hematology, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Scuro 1, Verona, 36100, Italy

    Roberta Zanotti

  3. AllergieZENTRUM, Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Frauenlobstr. 9-11, Munich, 80337, Germany

    Franziska Ruëff

Authors
  1. Patrizia Bonadonna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roberta Zanotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Franziska Ruëff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Franziska Ruëff .

Editor information

Editors and Affiliations

  1. San Antonio Allergy and Asthma Clinic, San Antonio, Texas, USA

    Theodore M. Freeman

  2. Allergy, Asthma & Immunology Associates P.C., Omaha, Nebraska, USA

    James M. Tracy

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Bonadonna, P., Zanotti, R., Ruëff, F. (2017). Insect Sting Allergy and Mast Cell Disease. In: Freeman, T., Tracy, J. (eds) Stinging Insect Allergy. Springer, Cham. https://doi.org/10.1007/978-3-319-46192-2_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-46192-2_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46190-8

  • Online ISBN: 978-3-319-46192-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation