ABSTRACT
This chapter highlights the importance of clinical history and appropriate use of available investigations, including component resolved diagnosis, in making an accurate diagnosis of insect venom allergy. The order of Hymenoptera includes a broad range of insects. Within this, three families account for majority of insect venom allergy in humans: apidae, vespidae, and formicidae. Venom immunotherapy is the only specific treatment currently available for reducing/preventing systemic reactions/anaphylaxis to future stings. It must be used only in patients with demonstrable sensitization to the respective venom and with a history of systemic reaction/s or anaphylaxis. Venom immunotherapy is recommended for patients who have had anaphylaxis or severe systemic reaction/s unless there are contraindications to treatment. Mastocytosis refers to a continuum or a spectrum of disorders characterized by an abnormal, clonal proliferation of mast cells. Recent evidence has indicated that as many as 4% of venom allergy patients may have an underlying mast cell disorder, and insect-sting anaphylaxis may be first clinical presentation.
