Leech-bite induced anaphylaxis with or without Hymenoptera venom sensitization
Wanandy T, Bradley I, Tovar Lopez CD, Cotton BTB, Handley SA, Mulcahy EM, Adriana Le TT, Lau WY (2024) · The Journal of Allergy and Clinical Immunology: In Practice · n=0
Характеристика исследования
- Дизайн
- case series with immunologic characterization of patients presenting with leech-bite-induced anaphylaxis with and without concurrent Hymenoptera (bee/wasp) venom sensitization (Department of Clinical Immunology and Allergy, incorporating the Jack Jumper Allergy Program, Royal Hobart Hospital, Hobart, Tasmania, Australia)
- Размер выборки (n)
- —
- Вмешательство
- Clinical immunologic characterization including serum tryptase, specific IgE measurements, and component-resolved diagnostics in patients presenting with anaphylaxis after leech bite; cross-reactivity with Hymenoptera venom allergens evaluated
- Компаратор
- Comparison of leech-bite anaphylaxis patients with and without Hymenoptera venom sensitization (within-cohort allergy phenotype analysis)
- Первичная конечная точка
- Identification of leech-bite-specific anaphylaxis cases and characterization of cross-reactivity patterns with Hymenoptera venom allergens
- Основной результат
- Documented Australian clinical experience of anaphylaxis following leech bites in environmental (non-medical) exposures, with characterization of specific IgE patterns and cross-reactivity with Hymenoptera venom in a subset of patients; abstract emphasizes the need for clinical recognition of leech-bite anaphylaxis as a distinct entity requiring allergy workup
- Длительность наблюдения
- duration of immunologic workup plus subsequent specialty follow-up (variable)
- PMID
- 39067855
Ключевые выводы
- Australian case series adding to the global literature on leech-bite-induced anaphylaxis
- Documents immunologic cross-reactivity between leech salivary allergens and Hymenoptera venom in a subset of patients
- Highlights need for pre-therapy allergy history screening in patients receiving medical leech therapy
- Reinforces that leech-bite anaphylaxis is a real (though rare) clinical entity requiring specialty allergy workup
- Adds Tasmanian/Australian geographic representation to the leech-allergy safety literature
Ограничения
- Small case series — incidence rates cannot be estimated from these data
- Mostly environmental (non-medical-leech) exposures — direct relevance to K040187 medical leech therapy is contextual
- Specific allergens identified by molecular methods only — clinical risk stratification still evolving
- No standardized desensitization protocol described
- Selection bias — dramatic anaphylaxis cases over-represented
Клиническое значение
Wanandy 2024 reinforces that leech-bite-induced anaphylaxis is a recognized clinical entity with documented cross-reactivity to Hymenoptera venom in a subset of patients. For US clinicians administering K040187-cleared medical leech therapy, the trial supports routine pre-therapy allergy history screening (including history of bee/wasp sting reactions), readiness to recognize and manage anaphylaxis, and appropriate consultation with allergy/immunology specialists for high-risk patients. The trial complements the broader leech-allergy literature (Li 2025, Tas 2025 Kounis syndrome) and underpins ASH's standing safety guidance that leech therapy requires clinician supervision and appropriate emergency response capability.
Связанные исследования
Leech Me Alone! Atraumatic Hemarthrosis after Hirudotherapy
Curcio J, Lloyd CM (2020)
Time to Reconsidering the Potential Role of Leech Salivary Proteins in Medicine: Type-II Kounis Syndrome Triggered by Leech Bite
Tas S, Yildiz BS, Ersin A, Tas U (2025)
Unusual, Uncommon, Intriguing, and Significant Causes of Kounis Syndrome: Important Medications and Chemicals Used to Treat Kounis Syndrome and Myocardial Infarction Can Cause Kounis Syndrome
Kounis NG, de Gregorio C, Hung MY, Giamouzis G, Michalaki MA, Özkan U, Ceasovschih A, Mplani V, Dousdampanis P, Kouni SN, Stefanidis A, Nastouli KM, Bozika M, Patsouras N, Koniari I (2025)
Non-Occlusive Mesenteric Ischemia Due to Hirudotherapy: A Case Report
Akalın Ç, Ekmen N (2020)