Anaphylactic reactions to Hymenoptera stings in asthmatic patients*

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Abstract
Cases (587) with generalized reactions to stings of Hymenoptera were evaluated. Eighty of these patients and 28 normal controls had radioallergosorbent tests (RAST) to venoms of honey bee, yellow jacket, hornet, wasp and to phospholipase A. Those patients with systemic reactions had a significantly greater frequency of positive RAST than normal controls (51.3% vs. 7.1%, P < 0.001). The frequency of atopy (asthma/rhinitis) in these 587 cases was only 22%, and resembled the expected frequency in a general population. Asthmatic patients apparently do not have an increased risk of developing systemic reactions to Hymenoptera stings. Those asthmatic patients with systemic reactions to Hymenoptera stings had a significantly more severe anaphylactic reaction to a sting than non-asthmatics. These severe reactions were primarily manifested by acute dyspnea, which appeared to represent a bronchospastic response to endogenous histamine release.