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Læknablaðið - 15.12.2003, Side 23

Læknablaðið - 15.12.2003, Side 23
FRÆÐIGREINAR / OFNÆMISLOST fékk ofnæmislost og er nú meðhöndlaður með af- næmingu gegn geitungum. Slík meðferð er mjög ár- angursrík og hindrar ofnæmislost við endurstungu í yfir 95% tilfella. Fái sjúklingar ekki rétta greiningu og meðferð fá þeir oftast svipuð einkenni við endur- stungu. I þessari grein er lýst helstu skordýrum sem stinga eða bíta hér heima og erlendis. Einnig er lýst ein- kennum við stungurnar. Nauðsynlegt er að greina of- næmið með húðprófum. Með fyrirhyggju er oft hægt að forðast skordýr. Fái einstaklingur ofnæmislost er nauðsynlegt að hefja meðferð með afnæmingu gegn því skordýri sem olli einkennunum. Algengt er að bit valdi staðbundnum einkennum í húð umhverfis stungustað og í þeim tilvikum þarf ekki að með- höndla með afnæmingu, jafnvel þó að húðpróf séu jákvæð. Heimildir 1. Neugut AI, Ghatak AT, Miller RL. Anaphylaxis in the United States: An investigation into its epidemiology. Arch Intern Med 2001;161:15-21. 2. Yocum MW, Butterfield JH, Klein JS, Volcheck GW, Schroeder DR, Silverstein MD. Epidemiology of anaphylaxis in Olmsted County: A population-based study. J Allergy Clin Immunol 1999; 104: 452-6. 3. Golden DB. Epidemiology of allergy to insect venoms and stings. Allergy Proc 1998; 10103. 4. Ólafsson E. Stungur geitunga. Náttúrufræðingurinn 2002; 70: 197-204. 5. Golden DB. Stinging insect allergy. Am Fam Physician 2003; 67: 2541-6. 6. Portnoy JM. Stinging insect hypersensitivity: A practice para- meter. J Allergy Clin Immunol 1999; 103: 963-80. 7. Edwards R. Social wasps. Their biology and control. 1980; Rentokil Ltd, East Grinstead: 397. 8. Ólafsson E. Um geitunga (Hymenoptra, vespidae) og skyldar gaddvespur á íslandi.Náttúrufræðingurinn 1979; 49: 27-40. 9. Kristjánsson K. Honningbier og vilde bier i Island. Tidskrift for biavl 1992; 1:10-6. 10. McCormack DR, Salata KF, Hershey JN, Carpenter GB, Engler RJ. Mosquito bite anaphylaxis: immunotherapy with whole body extracts. Ann Allergy Asthma Immunol 1995; 74:39-44. 11. Brummer-Korvenkontio H, Lappalainen P, Reunala T, Palus- uo T. Detection of mosquito saliva-specific IgE and IGG4 antibodies by immunoblotting. J Allergy Clin Immunol 1994; 93:551. 12. Georgitis JW, Reisman RE. Venom skin tests in insect-allergic and insect non-allergic populations. J Allergy Clin Immunol 1985; 76: 803. 13. Reisman RE, Wypych JI, Abersman CE. Stinging insect aller- gy: detection and clinical significance of venom IgE anti- bodies. J Allergy Clin Immunol 1975;56:443. 14. Sobotka AK, Adkinson JF Jr, Valentine MD, Lichtenstein LM. Allergy to insect stings. V. Diagnosis by radioallergo- sorbent tests (RAST). J Immunol 1978; 121: 2477. 15. Golden DB. Natural history of Hymenoptera venom sensiti- vity in adults. J Allergy Clin Immunol 1997; 100: 760-6. 16. Suck R, Weber B, Kahlert H, Hagen S, Cromwell O, Fiebig H. Purification and immunobiochemical characterization of folding variants of the recombinant major wasp allergen Ves v 5 (antigen 5). Int Arch Allergy Immunol 2000; 121: 284-91. 17. Mueller UR, Dudler T, Schneider T, Crameri R. Type 1 skin reactivity to native and recombinant phospholipase A2 from honeybee venom is similar. J Allergy Clin Immunol 1995; 96: 395-402. 18. Stapel SO, Waanders-Lijster de Raad J, von Toorenenbergen AW, de Groot H. Allergy to bumble-bee venom II. IgE cross- reactivity between bumble-bee and honey-bee venom. Allergy 1998; 52: 276-8. 19. Simons FE. Peng Z. Mosquito allergy: recombinant mosquito salivary allergens for new diagnostic tests. Int Arch Allergy Immunol 2001; 124: 403-5. 20. Reisman RE. Allergy to Stinging Insects. Pp 253-64. In: Patterson R, Grammer LC, Greenberger PA. Allergic Dis- eases. Diagnosis and Management 5th edition 1997. Pub. Lippincott-Raven. 21. Valentine M, Schuberth K , Kagey-Sobotka A. The value of immunotherapy with venom in children with allergy to insect stings. N Engl J Med 1991; 323:1601-3. 22. Reisman R. Insect stings. N Engl J Med 1994; 331: 523-7. 23. Hoffman DR. Hymenoptra venoms: composition, standardi- zation and stability. In: Levine MI, Lockey RF ed. Monograph on insect allergy. Pittsburgh PA. American Academy of Allergy and Immunology 1995; 27. 24. Reisman RE, Wypych JI, Arbesman CE. Stinging insect aller- gy: detection and clinical significance of venom IgE anti- bodies. J Allergy Clin Immunol 1975; 56443. 25. Murrant T, Bihari D. Anaphylaxis and anaphylactoid reac- tions. Int J Clin Pract 2000; 54: 322-8. 26. Björnsdóttir US, Sigurðardóttir S, Ludvíksson BR. Ofnæmis- lost - algengi, meingerð, meðferð. Læknablaðið 2002; 88: 551- 9. 27. Barnard JH. Nonfatal results in third degree anaphylaxis from Hymenoptra stings. J Allergy 1970; 45: 90. 28. Mueller HL. Further experiences with severe allergic reac- tions to insect stings. N Engl J Med 1959; 261: 374. 29. Schwartz HJ, Kahn B. Hymenoptra sensitivity. II. The role of atopy in the development of clinical hypersensitivity. J Allergy 1970: 45: 87. 30. Reisman RE. Natural history of insect sting allergy: relation- ship of severity of symptoms of initial sting anaphylaxis to re- sting reactions. J Allergy Clin Immunol 1992; 90: 335. 31. Ewan PW. New insight into immunological mechanisms of venom immunotherapy. Curr Opin Allergy Clin Immunol 2001; 1: 367-74. 32. Reisman RE, Livingston A. Venom immunotherapy (VIT): ten years experience with administration of single venoms and fifty micrograms maintenance doses. J Allergy Clin Immunol 1992; 85: 210. 33. Noon L. Prophylactic inoculation against hay fever. Lancet 1911; 1:1572. 34. Wilson AB, Deighton J, Lachmann PJ, Ewan PW. A compara- tive study of IgG subclass antibodies in patients allergic to wasp or bee venom. Allergy 1994; 49: 272-80. 35. Ewan PW, Deighton J, Wilson AB, Lachmann PJ. Venom-spe- cific IgG antibodies in bee and wasp allergy: lack of correlation with protection from stings. Clin Exp Allergy 1993; 23: 647-60. 36. Golden DB, Meyers DA, Kagey-Sobotka A, Valentine MB, Lichtenstein LM. Clinical relevance of the venom-specific immunoglobulin G antibody level during immunotherapy. J Allergy Clin Immunol 1982; 69: 489-93. 37. McHugh SM, Deighton J, Stewart AG, Lachmann PJ, Ewan PW. Bee venom immunotherapy induces a shift in cytokine responses from a TH-2 to a TH-1 dominant pattern: compari- son of rush and conventional immunotherapy. Clin Exp Allergy 1995; 25: 828-38. 38. Jutel M, Pichler WJ, Skrbic D, Urwyler A, Dahinden C, Muller UR. Bee venom immunotherapy results in decrease of IL-4 and IL-5 and increase of IFN-gamma secretion in specifíc allergen- stimulated T cell cultures. J Immunol 1995; 154: 4187-94. 39. Smits HH, van Rietschoten JG, Hilkens CM, Sayilir R. Stie- kema F, Kapsenberg ML, et al. IL-12 induced reversal of human Th2 cells is accompanied by full restoration of IL-12 responsiveness and loss of GATA-3 expression. Eur J Immunol 2001; 31:1055-65. 40. Bellinghausen I, Metz G, Enk AH, Christmann S, Knop J, Saloga J. Insect venom immunotherapy induces interleukin - 10 production and a Th2 to Thl shift, and changes surface marker expression in venom-allergic subjects. Eur J Immunol 1997; 27:1131-9. 41. Blaser K. Allergen dose dependent cytokine production regu- lates specific IgE and IgG antibody production. Adv Exp Med Biol 1996; 409:295-303. 42. Akdis CA, Blesken T, Akdis M, Wuthrich B, Blaser K. Role of interleukin-10 in specific immunotherapy. J Clin Invest 1998; 102:98-106. 43. Adkins CA, Blaser K. Mechanisms of allergen-specific immunotherapy. Allergy 2000; 55: 522-30. 44. Pierkes M, Bellinghausen I, Hultsch T, Metz G, Knop J, Saloga J. Decreased release of histamine and sulfidoleuko- trienes by human peripheral blood leukocytes after wasp venom immunotherapy is partially due to induction of IL-10 and IFN-gamma production of T cells. J Allergy Clin Immunol 1999; 103: 326-32. 45. Wang P, Wu P, Siegel MI, Egan RW, Billah MM. IL-10 inhibits transcription of cytokine genes in human peripheral blood mononuclear cells. J Immunol 1994; 153: 811-6. Læknablaðið 2003/89 939

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