Association of features of atopy and diagnostic parameters in hymenoptera venom allergy

In a total of 525 patients with hypersensitivity reactions to hymenoptera stings diagnostic parameters of hymenoptera venom (HV) allergy (severity of reactions, skin test threshold and RAST for bee and vespid venoms) were investigated for their relationship to the following indicators of atopy: positive history of atopic diseases, elevated (≤ 100 kU/1) total scrum IgE and positive prick test reactions to common inhalant allergens (CIA) (grass pollen, cat epithelium, house dust mite). There was a conclusive history of atopic disease in 25%, a total serum IgE ≥ 100 kU/1 in 48%, and at least one positive reaction to CIA in 53%. Total IgE ≥ 100 kU/l correlated with a higher frequency of RAST classes ≥ 2 (P < 0.01) and with less severe reactions to hymenoptera stings (P < 0.05). In the presence of at least one positive reaction to CIA, there were more frequently skin test thresholds ≤ 10 μg/ml (P < 0.05) and RAST classes ≥ 2 (P < 0.01) for HV than in CIA prick test negative individuals. There was no significant relationship between the other pairs of parameters evaluated. Thus, reactivity to HV in diagnostic tests is increased in the presence of certain indicators of atopy. This has to be considered in the interpretation of skin test and RAST results obtained with HV.