Allergy Asthma Respir Dis. 2014 Nov;2(5):344-351. Korean.
Published online Nov 28, 2014.
© 2014 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
Original Article

Hymenoptera venom anaphylaxis in adult Korean: a multicenter retrospective case study

Su-Kyoung Lee,1 Young-Min Ye,2 Hae-Sim Park,2 Gwang Cheon Jang,3 Young-Koo Jee,4 Hye-Kyung Park,5 Young-Il Koh,6 Joo-Hee Kim,7 Cheol-Woo Kim,8 Gyu-Young Hur,9 Mi Kyoung Kim,10 Tae-Bum Kim,11 Gil-Soon Choi,12 Sang-Heon Kim,13 Seong-Wook Sohn,1 and KAAACI Work Group for Urticaria/Angioedema/Anaphylaxis
    • 1Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
    • 2Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.
    • 3Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
    • 4Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
    • 5Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
    • 6Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
    • 7Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
    • 8Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
    • 9Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
    • 10Department of Internal Medicine, Chungbuk National University, Cheongju, Korea.
    • 11Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
    • 12Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
    • 13Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Received January 28, 2014; Revised April 03, 2014; Accepted May 07, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Purpose

We investigated the causes, clinical features, and risk factors of bee venom anaphylaxis in Korea.

Methods

The medical records of the diagnosis of anaphylaxis during a 5-year period from the 14 hospitals in Korea have been retrospectively reviewed. Cases of bee venom anaphylaxis were identified among anaphylaxis patients, and subgroup analyses were done.

Results

A total of 291 patients were included. The common cause of bee species was vespid (24.6%) in bee venom anaphylaxis, followed by honeybee and vespid (8.8%), apitherapy (7.7%), and honeybee (2.0%), although the causative bee species were commonly unknown (56.9%). The severity of anaphylaxis was mostly mild-moderate (72.9%), and common clinical manifestations included cutaneous (80.6%), cardiovascular (39.2%), respiratory (38.1%), and gastrointestinal (13.1%) symptoms. Portable epinephrine auto-injectors were prescribed to 12.1% of the patients. Subject positive to both vespid and honeybee showed more severe symptoms and higher epinephrine use (P<0.05). The severity was significantly associated with older age, but not with gender, underlying allergic disease, or family history. Apitherapy-induced anaphylaxis showed a higher rate of hospitalization and epinephrine use than bee sting anaphylaxis (P<0.05).

Conclusion

Vespid is the most common cause of bee venom anaphylaxis in Korea. It is suggested that positivity to honeybee and vespid may be associated with more severe symptoms.

Keywords
Hymenoptera; Bee venoms; Anaphylaxis; Apitherapy

Tables

Table 1
Clinical characteristics of subjects (n=291)

Table 2
Clinical manifestation of bee venom anaphylaxis

Table 3
Comparison of clinical parameters between the causes in bee venom anaphylaxis

Table 4
Comparison of clinical parameters between severe and mild-moderate bee venom anaphylaxis

Table 5
Comparison of clinical parameters between bee sting anaphylaxis and apitherapy

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