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Year : 2021  |  Volume : 35  |  Issue : 2  |  Page : 94-98

Successful treatment with a combination of bee venom immunotherapy and omalizumab for recurrent anaphylaxis after honey bee sting

1 National Allergy Centre, BLK Super Speciality Hospital, New Delhi, India
2 National Allergy Centre, New Delhi, India
3 Kashmir Institute of Allergy and Sleep Sciences, Srinagar, Jammu and Kashmir, India

Correspondence Address:
Dr. P C Kathuria
National Allergy Centre, BLK Super Speciality Hospital, 1/3 East Patel Nagar, New Delhi - 110 008
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijaai.ijaai_28_21

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Hymenoptera venom hypersensitivity reaction affects about 3% of the general population and a higher percentage (14%–43%) in beekeepers. Bee venom immunotherapy (bVIT) is effective in reducing subsequent severe systemic reactions and has a significant beneficial effect on disease-specific quality of life in both children and adults. In patients with a history of recurrent systemic anaphylactic reaction with bee venom, successful bVIT is difficult to achieve and can often lead to withdrawal of treatment. The combination of bVIT and omalizumab is a good option for these patients. Omalizumab is a humanized nonanaphylactogenic monoclonal anti-immunoglobulin (Ig) E antibody against the Cε3 domain of IgE to reduce the allergenicity, if combined with bVIT. We describe a successful treatment with combined omalizumab and bVIT in a case of recurrent anaphylaxis by honey bee sting hypersensitivity. Herein, subcutaneous omalizumab 150 mg was started 15 days before the initiation of bVIT and subsequently once a month for 30 months along with cluster doses of bVIT till the cumulative dose of 100 μg was achieved successfully.

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