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The development of negative skin tests in children treated with venom immunotherapy

1984; Elsevier BV; Volume: 73; Issue: 1 Linguagem: Inglês

10.1016/0091-6749(84)90485-8

1097-6825

David F. Graft, Kenneth C. Schuberth, Anne Kagey‐Sobotka, Kathy A. Kwiterovich, Yaffa Niv, Lawrence M. Lichtenstein, Martin D. Valentine,

Contact Dermatitis and Allergies

Twenty-eight of 62 children (45%) with a h&or?, of sting-induced anaphylaxis and initial!\.positive skin tests to venom(s) developed negative venom skin tests to one or more ~.$thc~WWW~ used in their treatment after 3 yr or more of immunotherap?.Children who developed negati~,~.venom skin tests were less sensitive prior to treatment, as judged by venom skin tests and \senom-specijc IgE antibody determinations, than children who maintained positive venom .thitrtests.Levels of venom-specijc IgE antibodies declined with time in most children, but to io~u levels in those with negative skin tests.Venom-specific IgG antibody levels were similar in both patients with negative skin tests and those with persistently positive skin tests.The developmetli of negutil'e skin tests may rejlect a loss of allergic sensitivit?; which is sujj?cient to alio~, :hc physician to consider the discontinuation of venom in.jection.c(J ALLEXCV CLIN IMUL'MI 73:6/&I.1984.)The length of time that venom treatment is necessary for prophylaxis of recurrent systemic reactions to insect stings has not been defined.This potential for a long treatment course arises from the fear that premature cessation of treatment might have grave consequences .l-4 At present, there are no guidelines for deciding the time when venom might be safely discontinued.We have found that, in the course of venom immunotherapy, a significant proportion of children develop negative venom skin tests.This was not anticipated because skin tests in pollen-treated individuals change minimally with time."The present report explores the immunologic correlates of this unexpected finding and its possible clinical utility in deciding when to stop therapy.