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

Su-Kyoung Lee; Young-Min Ye; Hae-Sim Park; Gwang Cheon Jang; Young-Koo Jee; Hye-Kyung Park; Young-Il Koh; Joo-Hee Kim; Cheol-Woo Kim; Gyu-Young Hur; Mi Kyoung Kim; Tae-Bum Kim; Gil-Soon Choi; Sang-Heon Kim; Seong-Wook Sohn

doi:10.4168/aard.2014.2.5.344

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Lee, Ye, Park, Jang, Jee, Park, Koh, Kim, Kim, Hur, Kim, Kim, Choi, Kim, Sohn, and KAAACI Work Group for Urticaria/Angioedema/Anaphylaxis: Hymenoptera venom anaphylaxis in adult Korean: a multicenter retrospective case study

Original Article

Allergy, Asthma & Respiratory Disease 2014; 2(5): 344-351.

Published online: 28 November 2014

DOI: https://doi.org/10.4168/aard.2014.2.5.344

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

Su-Kyoung Lee¹, Young-Min Ye², Hae-Sim Park²

, Gwang Cheon Jang³, Young-Koo Jee⁴, Hye-Kyung Park⁵, Young-Il Koh⁶, Joo-Hee Kim⁷, Cheol-Woo Kim⁸, Gyu-Young Hur⁹, Mi Kyoung Kim¹⁰, Tae-Bum Kim¹¹, Gil-Soon Choi¹², Sang-Heon Kim¹³, Seong-Wook Sohn¹; 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.

Correspondence to: Seong-Wook Sohn. Department of Internal Medicine, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang 410-773, Korea. Tel: +82-31-961-7148, Fax: +82-31-961-8449, seongwook@dumc.or.kr

Received 28 January 2014 Revised 3 April 2014 Accepted 7 May 2014

(open-access):

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

Figures and Tables

Table 1

Clinical characteristics of subjects (n=291)

Values are presented as number of subjects (%) unless otherwise indicated. Denominators are number of patients from which data collection was available.

SD, standard deviation.

Table 2

Clinical manifestation of bee venom anaphylaxis

Values are presented as number of subjects (%) unless otherwise indicated. Denominators are number of patients from which data collection was available.

SD, standard deviation; OPD, outpatient department; ER, emergency room; ICU, intensive care unit.

Table 3

Comparison of clinical parameters between the causes in bee venom anaphylaxis

Values are presented as number of subjects (%) unless otherwise indicated. Denominators are number of patients from which data collection was available.

SD, standard deviation; OPD, outpatient department; ER, emergency room; ICU, intensive care unit.

^*P-value is compared among Honeybee, Vespid, and Honeybee+vespid groups.

Table 4

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

Values are presented as mean±standard deviation/number or number of subjects (%). Denominators are number of patients from which data collection was available.

OPD, outpatient department; ER, emergency room; ICU, intensive care unit.

Table 5

Comparison of clinical parameters between bee sting anaphylaxis and apitherapy

Values are presented as number of subjects (%) or mean±standard deviation/number. Denominators are number of patients from which data collection was available.

OPD, outpatient department; ER, emergency room; ICU, intensive care unit.

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ORCID iDs: Hae-Sim Park
https://orcid.org/http://orcid.org/0000-0003-2614-0303
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