Allergy to hymenoptera

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; = ( )

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? (EAACI 2004): , ,

(C 2004): IgE

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, - :

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2010 Childrens Memorial Hospital

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ApismaliferaBombinaeVespinaePolistinaeApisApinaeBombusB. AgrorumB.ModusVespaDolichovespulaVespulaV.CrabroV.orientalisD.MaculataD.SaxonicaD.MediaV.GermanicaV.VulgarisV. MalcufronsV.RulaPolistesP.DominulusP. galicus

hornets vespa14

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Bumble-bee: - -

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Bombus barbutellus

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Vespa crabro

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Polistes, Paper ()

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Polistes anularis

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Polistes dominulus

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Dolichovespula maculata (white faced hornet)

.. . 23

Vespa orientalis

. 24

Vespula vulgaris = Common Wasp

hornets () 25

Common Wasp:

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HORNETS-AIR ()

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Vespula vulgaris UNDERGROUND ()

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Vespula (wasps ), Dolichovespula (media, saxonica, sylvestris), Vespa , Polistes . Vespa crabro ( hornets) . Polistes: P dominulus, galicus, nimphus

Vespula Dolichovespula: yellow jackets (underground, air). Hornets: Dolichovespula . white faced hornet: Dolichovespula maculata. Polistes (wasps ): annularis, fuscatus, metricus, exclamans

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& & .

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Apis mellifera- European honey bee &

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: > : > /

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/

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& (medline), o

(HLA-phenotype) /

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- ; ; a : , ACE inhibitors (-) : (Mastocytosis)

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( )

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: , , .

24 .

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() >10 cm, >24 .

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. 70 90% SPT 26 50% sIgE : IgE mediated / cell mediated .

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& & : , , , , , , , (200 1000 , > ) ,

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- 20% - 30% 10

, - 45% < 25 / 1 - >200 /

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- sIgE >1.0 kU/L, 12

- , (+) 17% .

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(QoL) ( + )

,

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?

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in vitro in vivo

=

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SOS!!! ;, , .

-

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_ () _ ( ) _ ( / )

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()

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JACI 1998; 102:173-6 Anderson. Im All Cl Nort Am2001; 21:4

SOS!!!! !!!! !!!!! . . , .. ( , EAACI, 2013)

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68 90 ( ) click 10

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Nicklas JACI 1998, 101: S465

! IV . !!!

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: ,

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() !!! 4-6 , : .

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( , & )

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20%

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. & &

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( & , )

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, , , . ...

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& & . ( Vespula spp- ). & .

: , . . . . & . , , , ..

Bumble-bee: , ( ).

: . . : , , , , .. : , . .

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. & , . . , , , , . , , - . , , , & . , - . . ( & CO2 ).

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( , ) . . : & . . (, , ..) . & ., , , . , . .

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. :

(, )

20%

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-

!!!

; IgE (RAST-CAP.FEIA)

-

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( tests) ( ) (Muller 1990). 1-2 (Bilo 2005).

SPT: 0,01-100 g/ml

ID: 0,001-1 g/ml

SPT, 100 g/ml< ID (Bjorkander 1980)

ID: 1 g/ml, >90%

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In vitro( ) , (Goldberg 1997, Mosbech 1986)

, , (Muller 1990)

sIgE (RAST, CAP, ADVIA)

(inhibition assays)

(recombinant)

(basophil activation test)

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2001-2009, 962 , ,

206 (26,4%)

baseline ( )

: , , , , .

interest group ci91

(Golden 2001)

, (Kontou Fili 2002)

11/51 ( IgE (Golden 2001)

(IgG+) IgG (EAACI 2005)

Golden RAST(1 ng/ml) IgE tvn spt92

() ( ) (?) (?) (?) (?)

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(Interest Group Insect Venom Allergy of the EAACI, n=840, Muller 2000) ( )

- vs

: :

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Forget-me-not105

!!!

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EAACI POSITION PAPER 2005
on

Diagnosis, Prevention & Treatment
of Hymenoptera venom Allergy

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