Fatal anaphylactic sting reaction in a patient with mastocytosis

We report on a 33-year-old female patient with indolent systemic
mastocytosis and urticaria pigmentosa who died of an anaphylactic
reaction after a yellow jacket sting. As she had no history of
previous anaphylactic sting reaction, there was no testing
performed in order to detect hymenoptera venom sensitization. But
even if a sensitization had been diagnosed, no venom immunotherapy
(VIT) would have been recommended. It is almost certain that VIT
would have saved her life and it is most likely that VIT is
indicated in some patients with mastocytosis with no history of
anaphylactic sting reaction. However, no criteria have been
established in order to allow a selection of mastocytosis patients
eligible for such a `prophylactic' VIT. Copyright (C) 2008 S.
Karger AG, Basel.