Honey Bee Venom IgE

Measures IgE antibodies to honey bee venom, which helps clinicians work out whether a sting reaction may be linked to bee venom.

AI-verified against cited sources. Awaiting expert reviewAlso called i1, i001, HBVLOINC 6844-5

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What it is

This test measures IgE antibodies to honey bee (Apis mellifera) venom (ImmunoCAP i1). Honey bees usually leave their stinger behind, and in some people the venom causes reactions that go beyond the sting site. Having IgE to the venom (sensitization) is common, and many people with it never have a serious reaction. Bee and wasp venoms share some features, so people can have IgE to both.

Why it matters

After a sting reaction, this test helps an allergist work out which insect was involved. That matters because venom immunotherapy, the only treatment that lowers the chance of further body-wide sting reactions, is chosen by venom type. A detectable result alone does not show how you would react to a future sting, so it is read with your sting history and, often, component tests and a tryptase level.

If it’s high

A level above your lab's range means your body has made more IgE to honey bee venom. It shows sensitization to bee venom. By itself it does not predict how you would react to a sting, and a higher number does not reliably mean a stronger reaction.

Common causes

Allergy to honey bee stings, including a past reaction
Past stings without any serious reaction
IgE to bee venom appearing alongside IgE to wasp or yellow jacket venom because the venoms share similar features
Frequent bee stings, such as in beekeeping
A very high total IgE (above about 2,500 kU/L), which can cause a false-positive reading

What can help

Ask your clinician whether you should see an allergist, especially if a sting ever caused hives away from the sting site, swelling of the face or throat, trouble breathing or dizziness
Ask whether component tests (such as Api m 1 and Api m 10) or yellow jacket and wasp tests would help sort out cross-reactivity
Ask about having a written plan for what to do after a sting

Usual ranges

What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.

For adults: 0–0.09 kU/L. Source: Mayo Clinic Laboratories, ARUP Laboratories, U.S. Food and Drug Administration.

Adults (this one applies)0–0.09 kU/L
Sources: Mayo Clinic Laboratories, ARUP Laboratories, U.S. Food and Drug Administration

ImmunoCAP IgE classes (Mayo Clinic Laboratories wording)

Class 0: negativebelow 0.1 kU/L
Class 0/1: borderline or equivocal0.1 to under 0.35 kU/L
Class 1: equivocal0.35 to under 0.7 kU/L
Class 2: positive0.7 to under 3.5 kU/L
Class 3: positive3.5 to under 17.5 kU/L
Class 4: strongly positive17.5 to under 50 kU/L
Class 5: strongly positive50 to under 100 kU/L
Class 6: strongly positive100 and above kU/L

Labcorp Hymenoptera venom report classes

Class 0: negativebelow 0.1 kU/L
Class 0/I: equivocal or low0.1 to under 0.32 kU/L
Class I: low0.32 to under 0.56 kU/L
Class II: moderate0.56 to under 1.41 kU/L
Class III: high1.41 to under 3.91 kU/L
Class IV: very high3.91 to under 19.01 kU/L
Class V: very high19.01 to under 100.01 kU/L
Class VI: very high100.01 and above kU/L

What can affect your result

Timing after a sting: results can come back negative in the first weeks, so a negative test soon after a reaction is repeated at least 4 to 6 weeks after the sting
Cross-reactivity: bee and wasp venoms share similar proteins and sugar groups, so double positives are common
Baseline tryptase: a higher level is linked to more severe sting reactions, so clinicians often check it as well
A very high total IgE (above about 2,500 kU/L) can cause false-positive results
The lab and test brand, because results from different systems are not directly comparable
Testing in the first weeks after a sting reaction can come back negative; the German DGAKI guideline says a negative result obtained less than 2 weeks after the sting should be repeated at least 4 to 6 weeks after the sting.
Bee and wasp venoms share similar proteins and sugar groups (cross-reactive carbohydrate determinants), so IgE to one can show up with the other.
A very high total IgE (above about 2,500 kU/L) can cause false-positive results through nonspecific binding (Mayo Clinic Laboratories).
Different labs and test brands give different numbers for the same blood sample, so compare results from the same lab and system.
Some labs reject hemolyzed, icteric or lipemic samples (ARUP).

Slow. It usually shifts over months to years, not weeks.

When to talk to a clinician

Call 911 or your local emergency number right away if, after a sting, you have trouble breathing, swelling of the face, lips or throat, dizziness or fainting, repeated vomiting, or hives that spread beyond the sting site. If you have ever had a body-wide reaction to a sting, talk with a clinician about seeing an allergist, even if this result is in the usual range.

Questions you could ask

Should my tryptase level be checked?
How often, if at all, should we recheck this?
Do my results fit with the insect that stung me?
Would component or wasp tests help clarify this?
Should I see an allergist about stings, and should I have a plan for future stings?
My result is in the usual range but I had a reaction to a sting. Should it be repeated later?

Questions people ask

I tested positive to both bee and wasp venom. Am I allergic to both?

Not necessarily. Bee and wasp venoms share similar proteins and sugar groups, so IgE to one can show up with the other. Tests for individual venom proteins can help tell real double sensitization from cross-reactivity. Your allergist uses these results together with your sting history.

Can this test be negative even if I had a reaction to a sting?

Yes. Soon after a reaction, in the first couple of weeks, the result can come back negative, so guidelines advise repeating the test at least 4 to 6 weeks after the sting. A single negative result also does not fully rule out an allergy, so tell your clinician about any reaction.

Does a higher number mean a worse reaction next time?

Not reliably. The amount of IgE does not predict how severe a future reaction would be. Your allergist looks at your history of reactions, other test results and other factors.

Show the science and sources

For clinicians and researchers

Quantitative IgE to whole honey bee venom (ImmunoCAP i1). Reported as allergen-specific IgE by ImmunoCAP fluoroenzyme immunoassay in kUA/L, with calibrators traceable to the WHO IgE reference (IRP 75/502). The FDA-reviewed system has a limit of quantitation of 0.1 kUA/L and reports up to 100 kUA/L; its maker recommends a 0.35 kUA/L cutoff and tells each lab to set its own range (FDA review K173726). Honey bee venom has 12 characterized allergens, five of them available for component testing (Thermo Fisher): Api m 1 (phospholipase A2), Api m 2 (hyaluronidase), Api m 3 (acid phosphatase), Api m 5 (dipeptidyl peptidase IV) and Api m 10 (icarapin). Labcorp lists Api m 1, Api m 3 and Api m 10 as bee-specific marker allergens and Api m 2 and Api m 5 as cross-reactive with vespid venoms, while the German guideline counts sIgE to Api m 1, 2, 3, 4 or 10 as indicating primary bee sensitization, so labs and guidelines differ on Api m 2. Api m 10 is described as a marker for genuine honey bee sensitization, with relevant sensitization in 35 to 72% of honey bee venom-allergic patients across studies (Jakob 2020). Double positivity to bee and vespid extracts is common; CCD IgE or recombinant components help tell true co-sensitization from cross-reactivity (DGAKI 2023, Labcorp). Results obtained shortly after a sting can be negative; the DGAKI guideline advises repeating a negative result obtained less than 2 weeks after the sting at least 4 to 6 weeks after the sting. Baseline serum tryptase is part of risk assessment (Labcorp, Thermo Fisher). EAACI reports systemic sting reactions in up to 7.5% of adults and up to 3.4% of children, with venom immunotherapy as the only treatment that prevents further systemic reactions. Labcorp prints its own class table on its Hymenoptera venom reports (second band set).

LOINC 6844-5 (primary), 112168-0, 112152-4. Specimen: serum.

Sources

Honeybee Venom, IgE, Serum (test ID HBV), Mayo Clinic Laboratories
Allergen, Insects and Venom, Honey Bee IgE (ARUP test 0055039), ARUP Laboratories
Stinging Insect Venom Allergen Component Testing and Hymenoptera Venom Allergy Profile sample report (I001-IgE Honeybee), Labcorp
ImmunoCAP Specific IgE (allergen component f447) 510(k) decision memorandum K173726, U.S. Food and Drug Administration
i1 Honeybee (Allergen Encyclopedia), Thermo Fisher Scientific (Phadia)
The Honeybee Venom Major Allergen Api m 10 (Icarapin) and Its Role in Diagnostics and Treatment of Hymenoptera Venom Allergy, Current Allergy and Asthma Reports (2020)
Diagnosis and treatment of Hymenoptera venom allergy: S2k Guideline of the German Society of Allergology and Clinical Immunology (DGAKI), Allergologie Select (2023)
EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy, Allergy (2018)
Specific IgE antibody criteria for Japanese cedar, Uni-CAP method (Appendix 3, in Japanese), Ministry of the Environment, Japan
Allergy Testing units (LOINC Community Forum thread), Regenstrief Institute, LOINC Community Forum

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.