{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T22:20:57Z","timestamp":1793485257494,"version":"4.5.0"},"reference-count":144,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2005,10,3]],"date-time":"2005-10-03T00:00:00Z","timestamp":1128297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2005,11]]},"abstract":"<jats:p>\n                    The purpose of diagnostic procedure is to classify a sting reaction by history, identify the underlying pathogenetic mechanism, and identify the offending insect. Diagnosis of Hymenoptera venom allergy thus forms the basis for the treatment. In the central and northern Europe vespid (mainly\n                    <jats:italic>Vespula<\/jats:italic>\n                    spp.) and honeybee stings are the most prevalent, whereas in the Mediterranean area stings from\n                    <jats:italic>Polistes<\/jats:italic>\n                    and\n                    <jats:italic>Vespula<\/jats:italic>\n                    are more frequent than honeybee stings; bumblebee stings are rare throughout Europe and more of an occupational hazard. Several major allergens, usually glycoproteins with a molecular weight of 10\u201350\u2003kDa, have been identified in venoms of bees, vespids. and ants. The sequences and structures of the majority of venom allergens have been determined and several have been expressed in recombinant form. A particular problem in the field of cross\u2010reactivity are specific immunoglobulin E (IgE) antibodies directed against carbohydrate epitopes, which may induce multiple positive test results (skin test,\n                    <jats:italic>in vitro<\/jats:italic>\n                    tests) of still unknown clinical significance. Venom hypersensitivity may be mediated by immunologic mechanisms (IgE\u2010mediated or non\u2010IgE\u2010mediated venom allergy) but also by nonimmunologic mechanisms. Reactions to Hymenoptera stings are classified into normal local reactions, large local reactions, systemic toxic reactions, systemic anaphylactic reactions, and unusual reactions. For most venom\u2010allergic patients an anaphylactic reaction after a sting is very traumatic event, resulting in an altered health\u2010related quality of life. Risk factors influencing the outcome of an anaphylactic reaction include the time interval between stings, the number of stings, the severity of the preceding reaction, age, cardiovascular diseases and drug intake, insect type, elevated serum tryptase, and mastocytosis. Diagnostic tests should be carried out in all patients with a history of a systemic sting reaction to detect sensitization. They are not recommended in subjects with a history of large local reaction or no history of a systemic reaction. Testing comprises skin tests with Hymenoptera venoms and analysis of the serum for Hymenoptera venom\u2010specific IgE. Stepwise skin testing with incremental venom concentrations is recommended. If diagnostic tests are negative they should be repeated several weeks later. Serum tryptase should be analyzed in patients with a history of a severe sting reaction.\n                  <\/jats:p>","DOI":"10.1111\/j.1398-9995.2005.00963.x","type":"journal-article","created":{"date-parts":[[2005,10,3]],"date-time":"2005-10-03T05:09:21Z","timestamp":1128316161000},"page":"1339-1349","source":"Crossref","is-referenced-by-count":444,"title":["Diagnosis of Hymenoptera venom allergy"],"prefix":"10.1111","volume":"60","author":[{"given":"B. M.","family":"Bil\u00f3","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Rueff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Mosbech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Bonifazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. N. 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