Near-fatal anaphylaxis after Hymenoptera venom immunotherapy

Abstract

Since Food and Drug Administration licensure in 1979, Hymenoptera venom extracts have been qualified for commercial release on the basis of tests for sterility, moisture content, protein content, and hyaluronidase enzymatic activity. Considering the potential risk for anaphylaxis associated with testing and escalating doses to maintenance, it is remarkable that no deaths have been reported from Hymenoptera venom immunotherapy (VIT). This report describes a case of near-fatal anaphylaxis that occurred in a patient receiving VIT after switching manufacturer's venom extract.