Purpose of review Unaware of the natural history of large local reactions caused by Hymenoptera stings, patients and clinicians are often concerned when faced with these reactions. These concerns include the difficulty in avoiding stings, the local discomfort, and the fear that the local reaction portends systemic, potentially life-threatening subsequent reactions. This review presents the historical studies that have assessed the natural history of large local reactions caused by Hymenoptera stings and, in doing so, provides rationale for the current consensus guidelines for the management of these reactions. Recent findings Retrospective and prospective studies in both adult and pediatric popula- tions have provided insight into the natural history of large local reactions caused by Hymenoptera stings dating back to the 1980s. Each of these studies has demonstrated a low risk of future systemic allergic reactions or anaphylaxis in patients with a history of large local reactions. Summary No clinical biomarker exists to determine the severity of future Hymenoptera sting reactions. Without a reliable clinical biomarker to identify those at risk for systemic allergic reactions or anaphylaxis, recommendations on the management of Hymenoptera sting reactions are derived from retrospective and prospective studies reviewed in this article. These studies provide strong
Current Treatment Options in Allergy – Springer Journals
Published: May 25, 2018
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