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Appropriate Evaluation and Therapy of Stinging Insect Hypersensitivity

Howard J. Schwartz, MD
Arch Intern Med. 1984;144(8):1560-1561. doi:10.1001/archinte.1984.00350200052005.
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Since the reports of anaphylactic allergy to stinging insects by Benson and Semenov1 in 1930, concerned physicians have attempted to validate a history of possible clinical Hymenoptera allergy by one or more test procedures. First, and simplest of them, has been skin testing by scratch, prick, or intradermal techniques with various types of insect preparations.

This concern for validation of the clinical history had as its goal an appropriate plan for management of the patient's condition.2,3 Thus, precise identification of hypersensitivity was crucial, and was complicated by several factors, including the inability of most persons (especially while under duress) to correctly identify these insects, problems of correct and precise memory of the event, and the physician's wish to differentiate between allergic reactions and those due to nonallergic mechanisms. Modern diagnostic methods use techniques of identifying insect-specific IgE antibodies; insect sting allergy is mediated by an IgE dependent reaction.


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