Hymenoptera sting in the head and neck region is not a risk factor for grade IV allergic reaction in venom allergic patients.

INTRODUCTION Hymenoptera insects stings (ISs) in the head and neck (H&N) region are commonly considered to be a risk factor for grade IV systemic reactions (IV-SYS-R) in Hymenoptera Venom Allergic patients (HVA). However, clinical data addressing this topic is scarce. OBJECTIVES The aim of our study was to verify whether ISs in the H&N region were related to a higher risk of IV-SYS-R in HVA patients. PATIENTS AND METHODS A cross-sectional retrospective study of a group of 195 patients aged 2-74 years treated with venom immunotherapy because of at least grade II systemic reaction to IS. Study sample included 109 adults (56%) (mean age 41.08±14.62 years, 50.5% males) and 86 children (mean age 9.53±4.37 years, 72.1% males, p<0.001 for age, p=0.002 for gender, respectively). IS localization was divided into seven categories. RESULTS H&N was the most common place of the IS (1/3 of study group). In the entire study population, the risk of IV-SYS-R was higher for ISs in the trunk (OR 1,58 (0,42-5,92) p=0.500), and legs (OR 1,56 (0,49-5,10) p=0.452) in comparison to the H&N region, but the difference was not significant. The H&N region when compared to all the other IS sites combined into one category demonstrated a lower, however non-significant, risk of IV-SYS-R (OR=0.87, 95%CI=0.43; 1.75, p=0.697). CONCLUSIONS H&N sting location was not confirmed to be a risk factor for IV-SYS-R regardless of age or gender.