Clonal mast cell diseases (CMDs) such as systemic mastocytosis (SM) are a significant risk factor for sting reactions (STs) and venom immunotherapy (VIT) adverse reactions, according to a recently published study in The Journal of Allergy and Clinical Immunology: In Practice.
“Hymenoptera venom-induced anaphylaxis is a severe and potentially fatal allergic reaction 71 that occurs rapidly after the sting. In the USA, the prevalence of systemic sting reactions 72 (SSR) among adults can reach up to 3.3%, while European epidemiological studies report prevalence rates as high as 7.5%,” the authors wrote.
Research shows that patients with high serum tryptase levels should undergo diagnostic testing for CMDs. Testing for a KIT p.D816V mutation through PCR assay is of particular importance in these cases.
Even patients with asymptomatic SM can suffer from severe STs; in fact, a severe ST can be the first clinical manifestation of SM.
Learn more about SM causes and risk factors
The Spanish Network on Mastocytosis (REMA) developed a screening tool based on laboratory and clinical findings to rule out SM in patients who develop STs. It uses baseline tryptase levels and clinical hallmarks such as dizziness and skin SM symptoms.
VIT is the preventive treatment of choice for patients with CMDs who suffer from STs. However, VIT can produce severe adverse effects. Important risk factors for VIT adverse reactions include the presence of preexisting cardiovascular or pulmonary disorders and elevated basal serum tryptase. CMDs are not associated with higher risk.
“We now have a more detailed understanding of risk factors for severe SSR and sAE during 307 VIT. Elevated BST levels, CMD, and higher age are well-established risk factors for severe 308 SSR,” the authors concluded.
