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Should a patient who has hereditary alpha tryptasemia and has experienced multiple anaphylactoid reactions be tested for a venom allergy and started on VIT if positive?

He cannot recall if he has been stung but if he did, it preceded his diagnosis and onset of symptoms, and he had no reaction. He has never been stung since his HaT symptoms started.
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Would you test a patient with HaT who has experienced multiple anaphylactoid reactions for a venom allergy?

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2 Answers
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Allergy & Immunology · Uniformed Services University
Answered on · Updated on

No. Only individuals with a history of anaphylaxis following a Hymenoptera insect sting should be offered venom-specific IgE testing and/or skin testing. There are rare exceptions, including beekeepers with frequent large local reactions. The person from the question stem does not have a history of ...

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Mednet Member
Mednet MemberInvited Expert
Allergy & Immunology · Columbia University
Answered on

HAT carriers *are* enriched in individuals with severe Hymenoptera anaphylaxis, and the Chollet and Akin paper, while important, is insufficiently powered to detect the presence or absence of clinical associations in HATS carriers vs controls in an unselected population.

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