Serum sickness reaction following multiple insect stings.

BACKGROUND

Anaphylaxis is the most common systemic allergic reaction caused by stinging insects. Serum sickness reactions occur much less frequently.

OBJECTIVE

To determine the level of venom-specific IgG and IgE antibodies during and after a serum sickness reaction to vespid venom.

METHODS

Case report; ELISA determination of venom-specific IgG and IgE; complement levels and tests for immune complexes were performed.

RESULTS

We report the case of a 66-year-old woman who developed a serum sickness reaction nine days after receiving multiple vespid stings. She developed urticaria, angioedema, fever, and arthralgias. She had elevated IgG and IgE venom-specific titers which declined during the recovery phase. Complement levels were normal and tests for immune complexes were negative. She was successfully treated with venom-specific immunotherapy without any serum sickness reaction.

CONCLUSIONS

A serum sickness reaction with elevated venom-specific IgG and IgE is reported with successful immunotherapy.