Abstract

OBJECTIVES:

To determine the incidence and nature of adverse events associated with the induction of rush Hymenoptera venom immunotherapy.

DESIGN:

Retrospective descriptive case study.

SETTING:

The asthma and allergy unit at a major metropolitan teaching hospital, between 1 January 1989 and 30 June 1999.

PATIENTS:

All patients with anaphylaxis to stings of Hymenoptera insects who received rush venom immunotherapy as inpatients.

OUTCOME MEASURES:

Hypersensitivity reactions to venom administration, including angioedema, skin rashes, hypotension and asthma, as well as any other adverse events related to the inpatient stay.

RESULTS:

68 venom-allergic patients received 73 courses of rush immunotherapy; 89% were desensitised to honey bee venom, 10% to yellow jacket wasp venom, and one to paper wasp venom. Hypersensitivity reactions occurred after 36 subcutaneous injections (3.8% of all injections given) in 26 patients (38%).

CONCLUSION:

In our cohort, immunotherapy was accompanied by a high incidence of adverse systemic events during the induction phase. Immunotherapy should only be given by experienced staff in centres where there are facilities for resuscitation.