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Case Report |
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Severe Anaphylaxis to Bee Venom
Immunotherapy: Efficacy of Pretreatment and Concurrent
Treatment With Omalizumab |
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C Galera,1 N Soohun,1
N Zankar,1 S Caimmi,1 C Gallen,2
P Demoly1 |
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1Allergy and Respiratory Diseases
Unit, Hôpital Arnaud de Villeneuve, University Hospital
of Montpellier, Montpellier, France
2 Allergy Unit, Narbonne Hospital, Narbonne, France |
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J Investig Allergol Clin Immunol
2009; Vol. 19(3): 225-229 |
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Abstract |
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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.
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