Clinical and laboratory profile of patients with anaphylaxis to fire ant
venom (Solenopsis sp) under specific subcutaneous immunotherapy
Abstract
Background: Anaphylaxis to fire ant venoms (Solenopsis sp) is a
significant cause of systemic reaction caused by Hymenoptera stings in
children. There are only a few reports about the safety and efficacy of
specific immunotherapy. Objective: Evaluate clinical characteristics,
IgE and IgG4 specific responses of patients undergoing immunotherapy
with a whole-body extract of Solenopsis sp after one year of the
maintenance phase. Materials and methods: Thirty-three patients were
enrolled due to anaphylaxis by fire ant venom (Solenopsis sp) and
underwent specific immunotherapy. They were assessed at baseline and one
year after the beginning of the maintenance phase for skin test;
specific venom IgE and IgG4 antibodies; tryptase. Results: All patients
included presented a severe anaphylactic reaction. Although two patients
(6.25%) presented a tryptase level higher than 11.4 ug/ml, systemic
mastocytosis was ruled out. There was no relationship between the
severity of the reaction with gender, tryptase level, atopy, previous
reactions, the allergen’s concentration in the skin test or specific IgE
level. There was an increase in the specific IgG4/IgE ratio between the
two time points. Reactions were local, with only two mild systemic
reactions during the build-up phase. Twenty patients had accidental
stings during immunotherapy, with 3 presenting only urticaria.
Conclusions: This study is unprecedented in evaluating clinical and
laboratory data in the fire ant immunotherapy. Our results show that
after one year of the maintenance phase, patients did not develop any
severe reaction with only a few mild reactions and presented a
significant production of specific IgG4.