Repeated anaphylactic shocks during bee venom immunotherapy and successful continuation of treatment after vaccine change

Aleksandra Misarko; Aleksandra Hejnosz; Krzysztof Piwowarek; Andrzej Chciałowski

doi:10.5114/pja.2025.152734

eISSN: 2391-6052
ISSN: 2353-3854

Alergologia Polska - Polish Journal of Allergology

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3/2025
vol. 12

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abstract:

Case report

Repeated anaphylactic shocks during bee venom immunotherapy and successful continuation of treatment after vaccine change

Aleksandra Misarko

^{1, 2}

,

Aleksandra Hejnosz

^{1, 2}

,

Krzysztof Piwowarek

³

,

Andrzej Chciałowski

³

Faculty of Medicine, Medical University of Warsaw, Poland
Scientific Association “Alergen” at the Department of Internal Medicine, Infectious Diseases and Allergology, Military Institute of Medicine – National Research Institute, Warsaw, Poland
Department of Internal Medicine, Infectious Diseases and Allergology, Military Institute of Medicine – National Research Institute, Warsaw, Poland

Alergologia Polska – Polish Journal of Allergology 2025; 12, 3: 212–217

DOI: https://doi.org/10.5114/pja.2025.152734

Online publish date: 2025/05/20

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The study aims to investigate potential causes of repeated anaphylactic reactions during immunotherapy and to analyze possible measures to be taken in such a situation. The reported patient experienced an anaphylactic reaction after taking a maintenance dose of immunotherapy. Despite changing the antihypertensive drug from an angiotensin-converting-enzyme inhibitor, during an attempt to restart immunotherapy, another anaphylactic reaction occurred. Systemic mastocytosis was excluded. Implementing immunotherapy with a different vaccine was successful. In the case of generalized anaphylactic reactions occurring during immunotherapy, it is advisable to analyze what other drugs the patient is taking and, if suspected, perform testing for systemic mastocytosis. The tolerance of the second vaccine may have been due to the presence of an aluminum hydroxide adjuvant, which allows for a slower release of the allergen. In some cases, changing the immunotherapy vaccine may be crucial due to potential sensitivity to non-venom components.

keywords:

Repeated anaphylactic shocks during bee venom immunotherapy and successful continuation of treatment after vaccine change

Aleksandra Misarko 1, 2 , Aleksandra Hejnosz 1, 2 , Krzysztof Piwowarek 3 , Andrzej Chciałowski 3

mastocytosis, VIT, anaphylactic reactions, bee allergy, immunotherapy vaccine

Aleksandra Misarko

^{1, 2}

,

Aleksandra Hejnosz

^{1, 2}

,

Krzysztof Piwowarek

³

,

Andrzej Chciałowski

³