Safety and changes in selected laboratory parameters in children with hymenoptera venom allergy treated with venom immunotherapy

Czech version

Authors: Kapustová Daniela ¹; Bánovčin Peter ¹; Kapustová Lenka ¹; Petrovičová Otília ¹; Malicherová Jurková Eva ¹; Mikler Ján ¹; Šlenker Branislav ¹; Suchá Pavlína ¹; Jeseňák Miloš ^1,2,3
Authors‘ workplace: Klinika detí a dorastu, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin ¹; Klinika pneumológie a ftizeológie, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin ²; Oddelenie klinickej imunológie a alergológie, Univerzitná nemocnica Martin ³
Published in: Čes-slov Pediat 2023; 78 (6): 308-314.
Category: Original Papers
doi: https://doi.org/10.55095/CSPediatrie2023/051

Overview

Introduction: Hymenoptera venom allergy is second most common cause of anaphylaxis in childhood. Currenty, the only causal therapy that can induce tolerance is venom immunotherapy (VIT). Aim: In our work, we focused on the analysis of selected clinical and laboratory characteristics in a group of pediatric patients with hymenoptera venom allergy treated with VIT.

Material and methods: We created a prospective study in which we gradually included 20 pediatric patients (13 boys, 7 girls), which fulfilled indication criteria for VIT. Data were collected from 2015 to 2022. We defined the basic characteristics of the set, we focused on the overall tolerance of treatment in pediatric patients and the occurance of adverse effects during VIT administration, we also performed blood sampling to determine the dynamics of immunological laboratory parameters in precisely determined time intervals.

Results: The mean age was 11 ± 4,37 years, with the mean age of firts systemic reactions after the hymenoptera sting 9,15 ± 3,58 years. Of the 20 enrolled patients, 14 were allergic to bee venom and 6 to waps venom. VIT was started at an average age of 10 ± 3,86 years, of which 2 patients started before the fifth year of life. The most frequently represented clinical manifestations of systemic reaction in our group were facial angioedema (70 %), dyspnea (65 %), urticaria (55 %) and whole body pruritus (45 %). We observed the occurence of the adverse effects most often during the initial phase of administration in terms of local reactions, whereas no patient developed a systemic reaction. Spontaneus re-exposure during VIT occured in 25 % of patients, whereas no patient developed a systemic reaction. During VIT we also noted dynamic changes in individual evaluated laboratory parameters with a gradual decrease of specific IgE against the extract and allergen component of hymenoptera venom and increase of specific IgG4 against the allergen extract.

Conclusion: Allergy to hymenoptera venom is classified as a serious to life-threating condition, while the only possible therapy nowadays that can prevent systemic reaction and improve the patient´s quality of life is VIT. A higher effectiveness of VIT and also a lower risk of treatment failure are described in pediatric patients. Our experencie clearly proves the effectiveness and safety of VIT in childhood and at the same time confirms positive changes in laboratory parameters indicating the induction of immune tolerance.

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