A recent review published in Allergo Journal International highlights the strong link between mastocytosis and serious allergic reactions to insect stings, especially from bees, wasps and other insects in the Hymenoptera family.
Mastocytosis is a condition where the body produces too many mast cells, which are part of the immune system and help trigger allergic reactions. In addition to systemic mastocytosis (SM) — the form of the disease that can affect many organs — there is a second form of mastocytosis that affects only the skin, called cutaneous mastocytosis.
If you have mastocytosis, you have a much higher risk of a life-threatening allergic reaction, called anaphylaxis, after an insect sting. These reactions often cause a sudden drop in blood pressure or fainting and may occur with few or no skin signs, like hives or rash.
Doctors use several tests to diagnose mastocytosis and insect venom allergy. These may include allergy tests to identify which insect stings you react to, blood tests to measure tryptase levels (high levels can indicate mastocytosis), genetic testing for a mutation called KIT D816V, and sometimes a bone marrow biopsy to check mast cells directly.
Read more about SM testing and diagnosis
Venom immunotherapy, a treatment that slowly trains the immune system to tolerate insect venom, is an essential treatment for people with venom allergy and mastocytosis. It is very effective and can save lives. However, people with mastocytosis may have more side effects during treatment. In some cases, another medicine called omalizumab is used to make venom immunotherapy safer.
Because mastocytosis does not go away, lifelong venom immunotherapy is often needed. It is also essential to be prepared for emergencies. This means always carrying epinephrine autoinjectors, having quick access to emergency services and making sure healthcare providers are aware of your condition. Allergists should also give patients an emergency card with important information to share in case of a severe allergic reaction.
“With diligent diagnosis and treatment, most patients can be well managed and protected from potentially life-threatening anaphylaxis caused by insect stings,” the review’s authors concluded.
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