How much specific is the association between hymenoptera venom allergy and mastocytosis?
Abstract
BACKGROUND: The preferential association of mastocytosis with hymenoptera sting reactions is well known, but there is no data on the prevalence of clonal mast cell disorders in subjects with severe systemic reactions due to foods or drugs. METHODS: Patients with food- or drug-induced severe systemic reactions, including anaphylaxis, and increased serum tryptase were studied for the presence of mastocytosis, and compared with a population of patients with hymenoptera allergy. The aetiological role of foods or drugs was assessed according to current recommendations. Systemic reactions were graded in severity according to the procedure described by Mueller. Serum tryptase was considered increased if the level was >11.4 ng/ml. Subjects with increased tryptase had dermatological evaluation and Bone marrow(BM) aspirate-biopsy, which included histology/cytology, flow cytometry and detection of KIT mutations. RESULTS: A total of 137 subjects (57 male, mean age 42 years) were studied. Of them, 86 proved positive for drugs and 51 for foods. Overall, out of 137 patients, only nine (6.6%) had a basal tryptase >11.4 ng/ml, and only two (1.5%) were diagnosed with mastocytosis. This was clearly different from patients with hymenoptera allergy, where 13.9% had elevated tryptase and 11.1% had a clonal mast cell disorder. CONCLUSION: The association of clonal mast cell disorders with hymenoptera allergy seems to be more specific than that with food- or drug-induced systemic reactions.
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The prevalence of SM is around 10% in patients experiencing anaphylaxis after Hymenoptera sting and 5% of all cases of anaphylaxis.
“the prevalence on SM sets around 10% in patients experiencing anaphylaxis after Hymenoptera sting (21, 61) and 5% of all cases of anaphylaxis (62, 63).”
From Defining “Normal” basal serum tryptase levels: a context-dependent approach to improve diagnostics in systemic mastocytosis (2025) · cites this paper as [61]
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- Authors
- Bonadonna, P., Zanotti, R., Pagani, M., Caruso, B., Perbellini, O., Colarossi, S., Olivieri, E., Dama, A., Schiappoli, M., Senna, G., Antico, A., & Passalacqua, G.
- Affiliations
- Azienda Ospedaliera Universitaria Integrata Verona (IT)
- University of Verona (IT)
- University of Bologna (IT)
- University of Genoa (IT)
- Corresponding author
- Passalacqua, G.
- ORCID
- Venue
- Allergy
- Publisher
- Wiley
- Published
- 2009-09
- Volume
- 64
- Issue
- 9
- Pages
- 1379-1382
- ISSN
- 0105-4538 (ISSN-L)
- 1398-9995
- OpenAlex
- W1966508137
- Cited by
- 87
- References
- 19
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 7 · 2022: 7 · 2021: 5 · 2020: 7 · 2019: 7 · 2018: 2 · 2017: 6 · 2016: 6 · 2015: 6 · 2014: 6 · 2013: 6 · 2012: 7
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Allergy (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
- Keywords
- hymenoptera venom allergy, mastocytosis, clonal mast cell disorders, serum tryptase, food-induced anaphylaxis, drug-induced anaphylaxis, KIT mutations, bone marrow biopsy, systemic allergic reactions
- MeSH terms
- Adolescent, Adult, Aged, Animals, Arthropod Venoms, Child, Child, Preschool, Female, Humans, Hymenoptera, Hypersensitivity, Male, Mastocytosis, Middle Aged, Tryptases, Young Adult
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