Current Practices in Diagnosis of Hymenoptera Venom Allergy in Poland

Introduction: Hymenoptera venom allergy (HVA) is associated with a high risk of anaphylaxis. Effective treatment of HVA patients requires allergologists' familiarity with the latest HVA recommendations.

Aim: Evaluation of current practices in HVA diagnosis in Poland.

Material And Methods: A survey questionnaire was conducted in 32 HVA centres in Poland.

Results: The response rate was 97%. There were 1829 patients evaluated due to HVA in 2015. Sixty six percent ( = 21) of the centres used skin prick tests, out which 90% ( = 19) used 100 µg/ml of the venom extract as the highest concentration. All the centres performed intradermal tests (IDT) and serum specific IgE (sIgE), an initial diagnostic tool in 91% ( = 29). The highest venom concentration in IDT was 1 µg/ml in 75% ( = 24), 0.1 µg/ml in 16% ( = 5), 0.01 µg/ml in 3% ( = 1) and 10 µg/ml in 6% ( = 2). Baseline serum tryptase was assessed in 84% of the centres ( = 27), out of which 53% ( = 17) tested all their patients, whereas 31% ( = 10) checked only those with life-threatening reactions. In case of negative IDT/sIgE, 59% of the centres ( = 19) performed components evaluation, while 19% ( = 6) did the basophil activation test. In case of no identification of the culprit insect and sensitization to both venoms, VIT employed venom with higher sIgE.

Conclusions: Most allergology centres in Poland follow HVA guidelines. We identified two inaccuracies in their HVA management including non-adequate venom concentration in IDT and a false belief in correspondence between sIgE concentration and severity of allergic reactions.