Skip to main content

Hymenoptera Venom Allergy (HVA) With Components Profile, II

Test Number 606895
Test number copied
CPT

83520; 86003(x6); 86008(x8)

Test Details

Methodology

Thermo Fisher ImmunoCAP® Allergen-specific IgE

Result Turnaround Time

4 - 6 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Information

Related Documents

Test Includes

This test includes the standard Hymenoptera Venom Allergy (HVA) With Components Profile [606220] with tests for three additional venom extracts (bumblebee; white face hornet and yellow hornet).

Test No. 606220 includes the following:

Honey Bee Venom (HBV) IgE plus IgE to HBV components Api m 1, Api m 2, Api m 3, Api m 5, & Api m 10; Yellow Jacket Venom (YJV) IgE plus IgE to YJV components Ves v 1 & Ves v 5; Paper Wasp Venom (PWV) IgE plus IgE to PWV component Pol d 5; Tryptase.

Reflex criteria: If any of the following are true, Cross-reactive Carbohydrate Determinant (CCD) IgE is performed: Honey Bee Venom (HBV) IgE ≥0.10 kU/L and all HBV components negative (<0.10 kU/L); Yellow Jacket Venom (YJV) IgE ≥0.10 kU/L and all YJV components negative (<0.10 kU/L); Paper Wasp Venom (PWV) IgE ≥0.10 kU/L and PWV component Pol d 5 negative (<0.10kU/L).

Use

This test supports the diagnosis of hymenoptera venom allergy (HVA) by detection of sIgE antibodies to whole venom extracts and individual allergenic venom proteins. Identifying sIgE responses to specific molecular targets with component resolved diagnostics (CRD) helps fine-tune the diagnosis by distinguishing species-specific, co-reactive, or cross-reactive sensitizations. An accurate diagnosis, in turn, facilitates treatment, including prescription of venom immunotherapy.1

Special Instructions

If reflex testing is performed, additional charges/CPT code(s) may apply.

Limitations

The high rate of asymptomatic sensitization to hymenoptera venom makes an accurate diagnosis of Hymenoptera venom allergy challenging.2-5

There is no correlation between the severity of sting reactions and the concentration of venom sIgE to whole venom extracts6-10 or individual components,11 and some patients with minimal level or absent specific IgE to these entities can develop severe anaphylaxis.

An increase in serum specific IgE levels after a sting is not an indicator for conversion into a clinically relevant hypersensitivity in patients with no history of severe systemic reaction to hymenoptera sting.5

sIgE to CCDs does not exclude clinical relevant sensitization to different venoms.12

Negative allergy test results can occur in patients with convincing history of sting-induced systemic reactions due to a number of causes including:

1. Testing performed in the refractory period following the sting reaction;

2. Loss of sensitization over time;

3. Sensitizing allergen component(s) under-represented in diagnostic test reagent;

4. The presence of systemic mastocytosis, as negative results occur in up to 15% of these patients.13

Specimen Requirements

Specimen

Serum

Volume

2.5 mL

Minimum Volume

1.5 mL (Note: This volume does not allow for repeat testing.)

Container

Gel-barrier tube

Stability Requirements

TemperaturePeriod
Room temperature14 days
Refrigerated14 days
Frozen3 months
Freeze/thaw cyclesStable x3

Storage Instructions

Room temperature

Footnotes

1. Sturm GJ, Arzt-Gradwohl L, Varga EM. Medical Algorithms: Diagnosis and treatment of Hymenoptera venom allergy. Allergy. 2019 Oct;74(10):2016-2018.30972798
2. Bilò MB, Bonifazi F. The natural history and epidemiology of insect venom allergy: clinical implications. Clin Exp Allergy. 2009 Oct;39(10):1467-1476.19622088
3. Golden DB. New directions in diagnostic evaluation of insect allergy. Curr Opin Allergy Clin Immunol. 2014 Aug;14(4):334-339.24915545
4. Schiener M, Graessel A, Ollert M, Schmidt-Weber CB, Blank S. Allergen-specific immunotherapy of Hymenoptera venom allergy - also a matter of diagnosis. Hum Vaccin Immunother. 2017 Oct 3;13(10):2467‐2481.28604163
5. Sturm GJ, Kranzelbinder B, Schuster C, et al. Sensitization to Hymenoptera venoms is common, but systemic sting reactions are rare. J Allergy Clin Immunol. 2014 Jun;133(6):1635-1643.e1.24365141
6. Golden DB, Moffitt J, Nicklas RA, et al. Stinging insect hypersensitivity: a practice parameter update 2011. J Allergy Clin Immunol. 2011 Apr;127(4):852-854.e1-e23.21458655
7. Krishna MT, Ewan PW, Diwakar L, et al. Diagnosis and management of hymenoptera venom allergy: British Society for Allergy and Clinical Immunology (BSACI) guidelines. Clin Exp Allergy. 2011 Sep;41(9):1201-1220.21848758
8. Sturm GJ, Heinemann A, Schuster C, et al. Influence of total IgE levels on the severity of sting reactions in Hymenoptera venom allergy. Allergy. 2007 Aug;62(8):884-889.17620065
9. Schäfer T, Przybilla B. IgE antibodies to Hymenoptera venoms in the serum are common in the general population and are related to indications of atopy. Allergy. 1996 Jun;51(6):372‐377.8837658
10. Biló BM, Rueff F, Mosbech H, Bonifazi F, Oude-Elberink JN; EAACI Interest Group on Insect Venom Hypersensitivity. Diagnosis of Hymenoptera venom allergy. Allergy. 2005 Nov;60(11):1339-1349.16197464
11. Gattinger P, Lupinek C, Kalogiros L, et al. The culprit insect but not severity of allergic reactions to bee and wasp venom can be determined by molecular diagnosis. PLoS One. 2018 Jun 25;13(6):e0199250.29940036
12. Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, et al. EAACI Molecular Allergology User’s Guide. Pediatr Allergy Immunol. 2016 May;27 Suppl 23:1-250.27288833
13. Alvarez-Twose I, Gonzalez de Olano D, Sanchez-Muñozz L, et al. Clinical, biological, and molecular characteristics of clonal mast cell disorders presenting with systemic mast cell activation symptoms. J Allergy Clin Immunol. 2010 Jun;125(6):1269-1278.e2.20434205

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
606895 Hymenoptera Venom Allergy II 602444 Class Description N/A
606895 Hymenoptera Venom Allergy II 602897 I205-IgE Bumblebee kU/L 6056-6
606895 Hymenoptera Venom Allergy II 602887 I002-IgE Hornet, White Face kU/L 6280-2
606895 Hymenoptera Venom Allergy II 602891 I005-IgE Hornet, Yellow kU/L 6288-5
606895 Hymenoptera Venom Allergy II 606260 I001-IgE Honeybee kU/L 6844-5
606895 Hymenoptera Venom Allergy II 606278 I208-IgE Api m 1 kU/L 60421-5
606895 Hymenoptera Venom Allergy II 606279 I214-IgE Api m 2 kU/L 79167-3
606895 Hymenoptera Venom Allergy II 606280 I215-IgE Api m 3 kU/L 94275-5
606895 Hymenoptera Venom Allergy II 606281 I216-IgE Api m 5 kU/L 94276-3
606895 Hymenoptera Venom Allergy II 606375 I217-IgE Api m 10 kU/L 82613-1
606895 Hymenoptera Venom Allergy II 606508 Reflex Information N/A
606895 Hymenoptera Venom Allergy II 606261 I003-IgE Yellow Jacket kU/L 6740-5
606895 Hymenoptera Venom Allergy II 606378 I211-IgE Ves v 1 kU/L 66714-7
606895 Hymenoptera Venom Allergy II 606379 I209-IgE Ves v 5 kU/L 60240-9
606895 Hymenoptera Venom Allergy II 606563 Reflex Information N/A
606895 Hymenoptera Venom Allergy II 606262 I004-IgE Paper Wasp kU/L 6198-6
606895 Hymenoptera Venom Allergy II 606380 I210-IgE Pol d 5 kU/L 63436-0
606895 Hymenoptera Venom Allergy II 606588 Reflex Information N/A
606895 Hymenoptera Venom Allergy II 004298 Tryptase ug/L 21582-2
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code602444
Result Code NameClass Description
UofM
Result LOINCN/A
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code602897
Result Code NameI205-IgE Bumblebee
UofMkU/L
Result LOINC6056-6
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code602887
Result Code NameI002-IgE Hornet, White Face
UofMkU/L
Result LOINC6280-2
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code602891
Result Code NameI005-IgE Hornet, Yellow
UofMkU/L
Result LOINC6288-5
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606260
Result Code NameI001-IgE Honeybee
UofMkU/L
Result LOINC6844-5
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606278
Result Code NameI208-IgE Api m 1
UofMkU/L
Result LOINC60421-5
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606279
Result Code NameI214-IgE Api m 2
UofMkU/L
Result LOINC79167-3
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606280
Result Code NameI215-IgE Api m 3
UofMkU/L
Result LOINC94275-5
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606281
Result Code NameI216-IgE Api m 5
UofMkU/L
Result LOINC94276-3
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606375
Result Code NameI217-IgE Api m 10
UofMkU/L
Result LOINC82613-1
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606508
Result Code NameReflex Information
UofM
Result LOINCN/A
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606261
Result Code NameI003-IgE Yellow Jacket
UofMkU/L
Result LOINC6740-5
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606378
Result Code NameI211-IgE Ves v 1
UofMkU/L
Result LOINC66714-7
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606379
Result Code NameI209-IgE Ves v 5
UofMkU/L
Result LOINC60240-9
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606563
Result Code NameReflex Information
UofM
Result LOINCN/A
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606262
Result Code NameI004-IgE Paper Wasp
UofMkU/L
Result LOINC6198-6
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606380
Result Code NameI210-IgE Pol d 5
UofMkU/L
Result LOINC63436-0
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code606588
Result Code NameReflex Information
UofM
Result LOINCN/A
Order Code606895
Order Code NameHymenoptera Venom Allergy II
Order Loinc
Result Code004298
Result Code NameTryptase
UofMug/L
Result LOINC21582-2
Reflex Table for Reflex Information
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 606381 O214-IgE CCD Determinants 606381 O214-IgE CCD Determinants kU/L 58984-6
Reflex 1
Order Code606381
Order NameO214-IgE CCD Determinants
Result Code606381
Result NameO214-IgE CCD Determinants
UofMkU/L
Result LOINC58984-6
Reflex Table for Reflex Information
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 606381 O214-IgE CCD Determinants 606381 O214-IgE CCD Determinants kU/L 58984-6
Reflex 1
Order Code606381
Order NameO214-IgE CCD Determinants
Result Code606381
Result NameO214-IgE CCD Determinants
UofMkU/L
Result LOINC58984-6
Reflex Table for Reflex Information
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 606381 O214-IgE CCD Determinants 606381 O214-IgE CCD Determinants kU/L 58984-6
Reflex 1
Order Code606381
Order NameO214-IgE CCD Determinants
Result Code606381
Result NameO214-IgE CCD Determinants
UofMkU/L
Result LOINC58984-6