Insect sting anaphylaxis in patients without detectable serum venom‐specific IgE

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Abstract
Summary: Following insect sting anaphylaxis, twenty‐five patients of over 500 evaluated, did not have detectable serum venom‐specific IgE. Twenty‐two were evaluated within 1 year of the reaction, fifteen within 6 months. Anaphylaxis occurred in six patients after their first sting exposure. The clinical features of the sting reaction were typical of the reaction occurring in insect‐allergic patients with serum venom‐specific IgE. Eleven of the twenty‐five patients had negative venom skin tests. These observations suggest that a non‐IgE mechanism may be responsible for a minority of insect sting reactions.