Use of sIgE/T-IgE in Predicting Systemic Reactions: Retrospective Analysis of 54 Honeybee Venom Allergy Cases in North China

BACKGROUND: Venom allergy is significantly underestimated in China. Venom-specific IgE may not provide accurate clinical reactions. Our conducted retrospective analysis observes alternative diagnostic considerations in assessing confirmation and severity of honeybee venom allergy. METHODS: Retrospective review of honeybee venom allergy versus nonallergy patients presented with positive honeybee venom (i1) sIgE results. According to clinically observed reactions caused by a honeybee sting, patients were divided into three groups. Patient residence and exposure types were analyzed. The sIgE/T-IgE among allergy and control groups was compared. RESULTS: Gender ratio male:female was 32:22; median age was 39 years (31, 50). 48% (26/54) of patients live in urban areas, 52% (28/54) in rural areas. Based on bee sting reactions, patients were divided into common localized reactions (32/54), large localized reactions (7/54), and systemic reactions (15/54). In the systemic reaction group, patients presented as Type II (6/15), Type III (6/15). There is significant difference (P < 0.001) between the three groups in regards to exposure types. In the systemic reaction group, 8.7% (13/15) of patients are beekeepers. A significant difference (P < 0.001) was observed between allergic and control groups based on sIgE/T-IgE results. As well as significant difference observed between the systemic reaction group to the other two reaction groups in regards to sIgE/T-IgE results. Six systemic reaction patients presented with large localized reactions before onset of system symptoms 1 month to 1 year of being stung. CONCLUSIONS: Occupational exposure is the most common cause in honeybee venom allergy induced systemic reactions. The use of sIgE/T-IgE results is a useful diagnostic parameter in determining honeybee venom allergy.