Pathogenesis (development of disease)
The allergic reaction to the venom (insect venom allergy) of bee/wasp (hymenoptera; hymenoptera venom allergy) is an immediate-type reaction.There is activation of mast cells (cells of the body’s own defense system that have stored certain messenger substances) and granulocytes (part of the white blood cells; defense cells) by IgE antibodies (special protein bodies with which the immune system fends off foreign pathogens). These release mediators, which in turn lead to symptomatology.
Etiology (causes)
Disease-related causes.
Injuries, poisonings, and other consequences of external causes (S00-T98).
- Insect bite
Risk factors of frequent bee/wasp sting exposure
Biographic causes
- Family members/neighborhood of beekeepers.
- Beekeepers
- Professions like:
- Bakery salesman
- Construction worker
- Firefighter
- Gardener
- Farmers
- Truck drivers
- Fruit seller
- Forestry worker
Behavioral causes
- Outdoor activities
Risk factors for severe anaphylaxis
Biographic causes
- Severe anaphylaxis due to an insect bite in self-history.
Behavioral causes
- Psycho-social situation
- Physical/psychological stress situations
Disease-related causes
Respiratory system (J00-J99)
- Bronchial asthma
Cardiovascular system (I00-I99)
- Cardiovascular disease, unspecified.
Neoplasms – tumor diseases (C00-D48).
- Mastocytosis – two main forms: cutaneous mastocytosis (skin mastocytosis) and systemic mastocytosis (whole body mastocytosis); clinical picture of cutaneous mastocytosis: Yellowish-brown spots of varying size (urticaria pigmentosa); in systemic mastocytosis, there are also episodic gastrointestinal complaints (gastrointestinal complaints), (nausea (nausea), burning abdominal pain and diarrhea (diarrhea)), ulcer disease, and gastrointestinal bleeding (gastrointestinal bleeding) and malabsorption (disorder of food absorption); In systemic mastocytosis, there is an accumulation of mast cells (cell type that is involved in, among other things, allergic reactions). Among other things, involved in allergic reactions) in the bone marrow, where they are formed, as well as accumulation in the skin, bones, liver, spleen and gastrointestinal tract (GIT; gastrointestinal tract); mastocytosis is not curable; course usually benign (benign) and life expectancy normal; extremely rare degeneration mast cells (= mast cell leukemia (blood cancer)).
Laboratory diagnoses – laboratory parameters considered independent risk factors.
- Basal serum tryptase concentration > 11.4 μg/l
Medications
- Beta-blockers (including eye drops) – group of drugs used to lower blood pressure such as metoprolol.
- ACE inhibitors – drug group for lowering blood pressure such as enalapril.
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (link not yet definitively proven).
Other causes
- Mild earlier sting reactions are considered an independent risk factor for later severe anaphylaxis
