Bone Marrow Disorder Common in Patients With Venom Allergy

People with venom allergies are more likely to suffer from mastocytosis, a bone marrow disorder that causes higher risk of fatal reactions.

The results, published in the Journal of Allergy and Clinical Immunology, revealed mastocytosis in fewer than 0.1% of venom allergy patients - almost 10 times more than those without allergies.

‘People with a history of severe venom allergy are at more risk of bone marrow disorder named Mastocytosis.’
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"Even though there is mounting interest, mast cell diseases are quite understudied; there are probably many people who go through life as some sort of 'medical mystery,' unaware of that diagnosis," says lead investigator Charles Schuler, M.D., a clinical assistant professor of allergy and immunology at Michigan Medicine.

"One way to find them is to find people with a venom allergy. This research strongly supports that and will help us more properly treat these patients."

Severe allergic reaction to a bee sting can often be the first sign of mastocytosis. It's the most common anaphylaxis trigger in that patient population.

Mastocytosis - Types, Causes, Symptoms, Diagnosis, Treatment and Prognosis
Mastocytosis is a rare condition marked by accumulation of mast cells under the skin and various organs in the body. Clinical features depend on site affected and treatment is based on specific symptoms in each person.

"While mastocytosis diagnoses are more prevalent in U.S. venom allergy patients, the numbers are significantly higher in Europe", says Cem Akin, M.D., senior author and clinical professor of allergy and immunology at Michigan Medicine.

"This suggests that there may be differences in sensitization patterns to bee and wasp venoms between Europe and the U.S.," Akin says.

"However, the European numbers may be overestimated due to referral and patient selection bias, as most of the centers publishing on the topic are referral facilities for mastocytosis. While Michigan Medicine is one of the world's largest referral centers for mastocytosis, we also have a large population of patients we follow for venom allergy."

The study included a five-year analysis of patients with history of severe venom allergy who underwent venom desensitization immunotherapy at Michigan Medicine. Elevated levels of tryptase, a chemical secreted by allergy cells, may predict if a person is at higher risk for reaction to immunotherapy.

"This study helps us account for the side effects or adverse outcomes associated with our current therapy," Schuler says. "Knowing this, allergists can be more watchful during sessions and watch for systemic reactions."

This study started out as a Michigan Medicine quality assurance project, and the paper is now the most comprehensive analysis of incidence of hymenoptera venom allergy and mastocytosis in the country, says James Baldwin, M.D., chief of Michigan Medicine's division of allergy and clinical immunology.

"It creates a picture of the burden of these conditions," Baldwin says. "It will inform both future research and public policy decisions in the field moving forward."

Source-Medindia