IMMUNOTHERAPY IN INSECT STING ALLERGY - C ASE-REPORTS OF THE COURSE OF IMMUNOLOGICAL AND CLINICAL-RESULTS OVER 6 YEARS

Several representative case report were selected from a prospective st udy on immunotherapy with an aluminum hydroxide adsorbed insect venom extract (Alutard SQ, ALK) in 35 insect sting allergic patients. Clinic al data (re-stings), antibody measurements (specific IgE-, IgG-, IgG4- antibodies) and skin test results are shown over a 6 year period. In 3 5 restings by the relevant insect only one patient with a prior anaphy lactic reaction to a bee sting reacted with an angio-edema. The antibo dy response patterns observed showed a large group of patients with a decrease of specific IgE and a very strong increase of specific IgG an d IgG4. Some patients showed a rather minimal decrease in IgE but ther e were in all patients marked increases of specific IgG and IgG4. In a few patients an increase of specific IgE at the begin of immunotherap y was observed, followed by a decrease in the following months. Also t he skin test reactivity decreased over three years, but only in a few patients the intracutaneous tests turned to be negative.