Severe Anaphylaxis to Bee Venom Immunotherapy: Efficacy of Pretreatment and Concurrent Treatment With Omalizumab

摘要

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.Key words: Bee venom allergy. Omalizumab. Immunotherapy.