Simultaneous intradermal testing with hymenoptera venoms is safe and more efficient than sequential testing

Allergy. 2013 Apr;68(4):542-4. doi: 10.1111/all.12123. Epub 2013 Feb 14.

Abstract

Background: According to current guidelines, skin testing for hymenoptera venom allergy should be performed in a stepwise manner, maintaining 15- to 20-min intervals between the injections of venom. Given the long-winded procedure of sequential skin testing, we retrospectively explored the safety of simultaneous intradermal testing.

Methods: Four hundred and seventy-eight consecutive patients with a convincing history of an anaphylactic reaction after a hymenoptera sting were tested. All venom concentrations (0.02 ml of 0.001, 0.01, 0.1, and 1.0 μg/ml of honey bee and wasp venom) were administered simultaneously to the skin.

Results: Four hundred and seventy-two (98.7%) patients tolerated the simultaneous intradermal test without any side-effects. Only three subjects (0.6%) had a presumed allergic reaction during the test; another three reactions were considered vasovagal.

Conclusion: Our skin test protocol with four simultaneously injected concentrations of two hymenoptera venoms is safe and permits the investigator to draw rapid conclusions about the individual's sensitization pattern.

MeSH terms

  • Adult
  • Allergens / administration & dosage
  • Anaphylaxis / immunology
  • Animals
  • Arthropod Venoms* / administration & dosage
  • Female
  • Humans
  • Hymenoptera / immunology*
  • Hypersensitivity, Immediate / diagnosis*
  • Intradermal Tests / adverse effects*
  • Male
  • Middle Aged
  • Skin Tests / adverse effects
  • Skin Tests / methods

Substances

  • Allergens
  • Arthropod Venoms