Comparison of moderate to severe systemic reactions with honeybee and wasp in children

Background The effect of the type of Hymenoptera on the severity of systemic reactions (SRs) is a controversial issue. The aim of the present study was to evaluate demographic, clinical, diagnostic, and therapeutic features of moderate‐to‐severe SRs in children with venom hypersensitivity and to compare the role of the honeybee and wasp stings in these reactions. Methods Data on children with moderate‐to‐severe SRs after a Hymenoptera sting were retrospectively collected for a 17‐year period. Results A total of 55 children with moderate‐to‐severe SRs (wasp: 44, honeybee: 11) to venom stings were included in the study. In the honeybee group, comorbid allergic rhinitis and any type of atopic disease was more frequent compared to the wasp group (p = 0.009 and p = 0.01, respectively). In 50.9% of the children, family history of SR to the same venom type was higher in the honeybee group (p = 0.02). Dyspnea was more frequent in the wasp, and cyanosis was more frequent in the honeybee compared to each other (p = 0.02 and p < 0.001, respectively). Prick tests results were significantly different between the groups (p = 0.038). There was no difference between honeybee and wasp in moderate‐to‐severe SR groups in terms of seasonal tendency, age at admission, age at first SR, gender, previous history of SR, sting localization, latency, and affected organ systems (p > 0.05 for each). Conclusion Moderate‐to‐severe SRs with honeybee and wasp venoms in children may differ in the severity of respiratory symptoms/signs at presentation, in addition to comorbidity of atopic diseases and family history of the SRs.