Insect stings can induce large local reactions or systemic reactions in allergic people. Hymenoptera venom immunotherapy (VIT) has shown efficacy to protect allergic individuals from new reactions after an insect sting in 77-96% of cases, both reducing morbidity and mortality and improving patient’s quality of life. Although during VIT patients tolerate an amount of venom greater than the content of the venom sac of the insect, there is no guarantee that a person will tolerate a live insect sting. Moreover, the lack of spontaneous stings generates an anxiety in some patients. All this remarks the need for a tool to demonstrate the degree of protection provided by VIT. Sting challenge test (SCT) with hymenoptera consist of causing a real sting in a patient diagnosed with an allergy to the venom of the stinging insect. SCT has been used to assess the efficacy of immunotherapy since its inception in the 50s and has also proven to increase patient’s quality of life. SCT in treated patients reassure those who prove to be protected and identify those who need a higher maintenance dose than the usual one. Currently there is no review or position paper available addressing sting challenge test. This position paper should be helpful to spread among clinicians the need of performing SCT as an essential part of the habitual clinical practice in hymenoptera venom allergy; to know the sting challenge procedure; and to improve clinical management of patients with this kind of allergy.

WG Insect Venom Hypersensitivity (IG Allergen Immunotherapy)

Chair: Arantza Vega Castro

Secretary: Elisa Boni