Severe anaphylaxis to bee venom immunotherapy: Efficacy of pretreatment and concurrent treatment with omalizumab

Céline Galera, N. Soohun, N. Zankar, S. Caimmi, C. Gallen, P. Demoly

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Abstract

Immunotherapy is an established mode of treatment for Hymenoptera venom anaphylaxis, although adverse reactions may occur. We report the case of a 33-year-old woman, the wife of a beekeeper, who experienced a systemic allergic reaction following a bee sting. Initial specific immunotherapy had to be stopped due to anaphylaxis (multiple immediate cardiovascular reactions). We looked for an alternative treatment option, and repeated immunotherapy accompanied by the anti-immunoglobulin (Ig) E monoclonal antibody omalizumab. Our new protocol was well tolerated. After 1 year of therapy, the patient was stung by a bee and developed only a slight local reaction, which resolved spontaneously. This result confirmed the success of our specific immunotherapy. We compared our results with those of 6 similar cases in the literature. Anti-IgE has provided a treatment option for patients with severe IgE-mediated allergic disease that is difficult to treat. This case suggests that omalizumab may be able to prevent anaphylaxis during immunotherapy.

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Keywords

  • Bee venom allergy
  • Immunotherapy
  • Omalizumab

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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