Drug and Venom Allergy in Mastocytosis

Matthew P Giannetti; Jennifer Nicoloro-SantaBarbara; Grace Godwin; Julia Middlesworth; Andrew Espeland; Mariana C Castells

doi:10.1016/j.iac.2023.04.002

Drug and Venom Allergy in Mastocytosis

Immunol Allergy Clin North Am. 2023 Nov;43(4):699-710. doi: 10.1016/j.iac.2023.04.002. Epub 2023 May 22.

Authors

Matthew P Giannetti¹, Jennifer Nicoloro-SantaBarbara², Grace Godwin³, Julia Middlesworth³, Andrew Espeland³, Mariana C Castells⁴

Affiliations

¹ Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, 41 Avenue Louis Pasteur, Alumni Hall, Room 303, Boston, MA 02115, USA; Harvard Medical School, 41 Avenue Louis Pasteur, Alumni Hall, Room 303, Boston, MA 02115, USA. Electronic address: mgiannetti@bwh.harvard.edu.
² Harvard Medical School, 41 Avenue Louis Pasteur, Alumni Hall, Room 303, Boston, MA 02115, USA; Department of Psychiatry, Brigham and Women's Hospital, 41 Avenue Louis Pasteur, Alumni Hall, Room 303, Boston, MA 02115, USA.
³ Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, 41 Avenue Louis Pasteur, Alumni Hall, Room 303, Boston, MA 02115, USA.
⁴ Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, 41 Avenue Louis Pasteur, Alumni Hall, Room 303, Boston, MA 02115, USA; Harvard Medical School, 41 Avenue Louis Pasteur, Alumni Hall, Room 303, Boston, MA 02115, USA.

PMID: 37758407
DOI: 10.1016/j.iac.2023.04.002

Abstract

Patients with mastocytosis have an increased risk for mast cell activation events including anaphylaxis when exposed to certain drugs and Hymenoptera venom. Hypotension and cardiovascular collapse without skin or other systemic manifestations can occur after Hymenoptera stings, during the perioperative period, and after exposure to nonsteroidal ntiinflammatory drugs, opioids, and other mast cell activating medications, including vancomycin and quinolones. This chapter reviews the epidemiology, mechanisms, diagnosis, management, and treatment options for Hymenoptera venom and drug-induced reactions in patients with mastocytosis.

Keywords: Antibiotics; Nonsteroidal antiinflammatory drugs (NSAIDs); Perioperative anaphylaxis; Vaccines.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Anaphylaxis* / diagnosis
Anaphylaxis* / epidemiology
Anaphylaxis* / etiology
Animals
Arthropod Venoms* / adverse effects
Humans
Hymenoptera*
Insect Bites and Stings* / chemically induced
Insect Bites and Stings* / complications
Mastocytosis* / diagnosis
Mastocytosis* / drug therapy
Mastocytosis* / epidemiology
Venom Hypersensitivity*

Substances

Arthropod Venoms