Cihan URAL, Ali KOKULUDAĞ, Aytül Zerrin SİN, Ramazan ERSOY, Okan GÜLBAHAR
Van Medical Journal - 2026;33(3):347-356
Introduction: Hymenoptera venom allergy is a major cause of IgE -mediated anaphylaxis. Optimal management includes prompt adrenaline administration, referral to an allergy specialist, prescription of an adrenaline au toinjector, and venom immunotherapy (VIT) when indicated. Despite established international guidelines, adherence to these recommendations in real -world practice remains suboptimal. This study aimed to evaluate real -world diagnostic and therapeutic practi ces in patients with Hymenoptera venom allergy in Türkiye and assess their concordance with current international guidelines. Materials and Methods: In this retrospective observational study, medical records of 238 patients diagnosed with honeybee and/or vespid venom allergy at the Ege University Allergy and Immunology Clinic between 1999 and 2010 were reviewed. Collected data in cluded demographic characteristics, sting location, reaction severity (Mueller classification), acute emergency management (adrenal ine administration and specialist referral), diagnostic testing (skin prick test and venom -specific IgE), adrenaline autoinjector prescription, and VIT-related outcomes (initiation, safety, and efficacy). Results: Systemic reactions occurred in 92.4% of pa tients, 76.4% of which were severe (Mueller grades 3 -4). Sting location was significantly associated with reaction severity (p = 0.011), with neck stings showing the highest rate of severe reactions (95%). Adrenaline was administered in only 43% of those w ith documented treatment information, 24% were referred to an allergy specialist, and 35.5% received an adrenaline autoinjector prescription. Venom sensitization wa s confirmed in 86.5%. Although VIT was recommended for 163 patients, only 50.9% initiated tr eatment. Among those who initiated VIT, 31% experienced mild -to-moderate injection -related adverse reactions, with no severe systemic reactions. No systemic reactions occurred following field re -stings among patients who completed VIT. Conclusion: The mana gement of Hymenoptera venom allergy in Türkiye remains suboptimal, primarily due to underuse of adrenaline, low referral rates to allergy specialists, and limited uptake of VIT. Strategies aimed at improving physician education, stan daring emergency man agement protocols, and enhancing access to VIT are essential to optimize patient outcomes and ensure guideline -concordant care.
