Letter
Delayed-onset cold anaphylaxis after hymenoptera sting

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  • Approach to Patients with Stinging Insect Allergy

    2020, Medical Clinics of North America
    Citation Excerpt :

    In contrast, those with anaphylaxis to a stinging insect have a high risk of future anaphylactic reactions (30%–60%).7,22,23 Serum sickness–like reactions24 and cold urticaria25 have been reported after insect stings. In addition, there are rare reports of non–IgE-mediated reactions to stinging insects, including nephropathy,26 neuropathy,27 rhabdomyolysis,28 and immune thrombocytopenic purpura.29

  • Delayed stinging insect reactions

    2017, Annals of Allergy, Asthma and Immunology
  • Stinging insect hypersensitivity: A practice parameter update 2016

    2017, Annals of Allergy, Asthma and Immunology
    Citation Excerpt :

    Serum sickness–like reactions to stings have occurred and may be associated with the presence of venom-specific IgE, but the mechanism of the reactions and the risk of anaphylaxis are unknown.60 Cold urticaria and cold-induced anaphylaxis have been reported after insect stings, generally without anaphylaxis.61,62 The prevalence of LLRs in the general population is approximately 10%, with estimates ranging from 2.4% to 26.4%, and higher among beekeepers (14%–43%).56,63

  • Insect sting allergy

    2016, Pediatric Allergy: Principles and Practice: Third Edition
  • Anaphylaxis to insect stings

    2015, Immunology and Allergy Clinics of North America
    Citation Excerpt :

    Although the definition of anaphylaxis seems to exclude reactions involving only cutaneous systemic manifestations (urticaria, angioedema, pruritus, flush), these are included in this article because they must be considered in diagnosis and treatment of insect allergy as potential precursors of more severe anaphylactic reactions. There are also reports of chronic urticaria and cold urticaria developing after insect stings, usually without any immediate hypersensitivity reaction, and with uncertain risk of anaphylaxis to a future sting.2,3 Unusual patterns of reaction have also been reported, including nephropathy, central and peripheral neurologic syndromes, idiopathic thrombocytopenic purpura, and rhabdomyolysis, but these are not IgE related.4

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