Frontiers in Medicine (Nov 2021)

Unusual Reactions to Hymenoptera Stings: Current Knowledge and Unmet Needs in the Pediatric Population

  • Riccardo Castagnoli,
  • Mattia Giovannini,
  • Francesca Mori,
  • Simona Barni,
  • Luca Pecoraro,
  • Luca Pecoraro,
  • Stefania Arasi,
  • Francesca Saretta,
  • Carla Mastrorilli,
  • Lucia Liotti,
  • Lucia Caminiti,
  • Gunter Johannes Sturm,
  • Gunter Johannes Sturm,
  • Gian Luigi Marseglia,
  • Elio Novembre

DOI
https://doi.org/10.3389/fmed.2021.717290
Journal volume & issue
Vol. 8

Abstract

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Hymenoptera stings are generally well-tolerated and usually cause limited local reactions, characterized by self-resolving erythema and edema associated with pain. However, Hymenoptera stings can induce immediate and delayed hypersensitivity reactions. In addition to these manifestations, unusual reactions to Hymenoptera stings have been reported. The latter are defined as unusual because of their atypical characteristics. They may differ from classical hypersensitivity reactions due to the stings' particular localization and the unusual involvement of one or more specific organs. Although unusual reactions to Hymenoptera stings are infrequent, it is essential for clinicians to know the possible related clinical manifestations. Here, we review the available literature and propose a diagnostic and management algorithm. At present, there are no defined guidelines for most of the unusual reactions to Hymenoptera stings, which should be managed in a tailored way according to the specifical clinical manifestations presented by the patients. Further studies are needed to better define these conditions and the underlying pathogenetic mechanisms to improve the diagnostic and therapeutic approach.

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