A Case for Venom Treatment in Anaphylactic Sensitivity to Hymenoptera Sting

In a child of a beekeeping family anaphylaxis developed after a honey-bee sting. He was treated with the conventional therapy, whole-(insect)-body extracts, for nine months. A second sting caused anaphylaxis again. Since the patient's family history included a sister who had died in similar circumstances, he was immunized with 1.4 mg of honey-bee venom over a two-month period; the last two doses were 100 μg (≅ two bee stings). His sensitivity to venom, assessed by basophil histamine release, decreased, and his blocking (IgG) antibody level increased 300 times over that after immunization with whole-body extract. After venom immunization he tolerated a honey-bee sting without reaction. The case and a review of pertinent data suggest that venom immunization may be the treatment of choice for hymenoptera sensitivity. (N Engl J Med 290:1223–1227, 1974)