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Blood Test Tracker

Paper Wasp Venom (Polistes) IgE

Measures IgE antibodies to paper wasp venom in your blood. A detectable result means you are sensitized, which is not the same as a sting allergy.

AI-verified against cited sources. Awaiting expert reviewAlso called i4, i004LOINC 6198-6

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What it is

Paper wasps (Polistes) are stinging insects. This test measures IgE, a type of antibody, to an extract of paper wasp venom (ImmunoCAP i4). Results come in kilounits per liter (kU/L), and many labs also print a class from 0 to 6. In the United States and southern Europe, allergic reactions to paper wasp stings are common.

Why it matters

For some people, a sting causes a serious allergic reaction called anaphylaxis. After a sting reaction, this test can help your clinician work out which insect may be involved. It is one piece of the picture, along with your sting history and often a skin test. Many adults have venom IgE without ever having a serious reaction. One review reports that 9.2 to 28.7% of adults are sensitized to the venom of stinging insects such as bees and wasps, while 0.3 to 7.5% have had a whole-body reaction to a sting.

If it’s high

A level above your lab's range means your immune system has made IgE against paper wasp venom. This is called sensitization. Many people with it have never had a serious sting reaction, so your clinician reads the result with your sting history. The number does not say how severe a future reaction could be.

Common causes

  • Sensitization without a serious sting reaction
  • A true paper wasp venom allergy
  • Cross-reacting IgE from other wasp venoms, such as yellow jacket, because the venoms share proteins
  • A very high total IgE (above about 2,500 kU/L), which can cause a false-positive reading

What can help

  • Talk with an allergist if a sting has ever caused symptoms beyond the sting site, such as hives elsewhere, swelling of the face or trouble breathing
  • Bring notes about the insect and what happened after the sting, because your history is a key part of the work-up
  • Ask whether a skin test or venom component tests would help sort out which insect is involved
  • Ask whether you need an emergency plan for future stings

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: ARUP Laboratories, Mayo Clinic Laboratories, U.S. Food and Drug Administration, Journal of Allergy and Clinical Immunology, Current Allergy and Asthma Reports, MedlinePlus, National Library of Medicine.

ImmunoCAP IgE classes (ARUP labels and 0.10 cutoff; Mayo Clinic Laboratories class edges from 0.35 up)

  • Class 0: no significant level detectedbelow 0.1 kU/L
  • Class 0/1: clinical relevance undetermined0.1 to under 0.35 kU/L
  • Class 1: low0.35 to under 0.7 kU/L
  • Class 2: moderate0.7 to under 3.5 kU/L
  • Class 3: high3.5 to under 17.5 kU/L
  • Class 4: very high17.5 to under 50 kU/L
  • Class 5: very high50 to under 100 kU/L
  • Class 6: very high100 and above kU/L

What can affect your result

  • Which insect stung you, since paper wasp, yellow jacket and hornet venoms share proteins and can cross-react
  • Mast cell conditions, which are more common in people with venom allergy and may raise the risk of severe sting reactions
  • Venom extracts can under-represent some venom proteins, so a negative result does not always rule out venom allergy
  • 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
  • Where a lab draws its cutoff (0.10 or 0.35 kU/L)
  • A very high total IgE (above about 2,500 kU/L) can cause false-positive results through nonspecific binding (Mayo Clinic Laboratories).
  • Antihistamines do not affect this blood test the way they affect skin-prick testing (NIAID 2010), but follow your clinician's instructions about any medicine before the test.
  • Venom extracts can under-represent some venom proteins, so a negative result does not always rule out venom allergy (Ollert and Blank 2015).
  • Different labs and test brands give different numbers for the same blood sample, so compare results from the same lab and system.

When to talk to a clinician

Call 911 or your local emergency number if, after a sting, you have trouble breathing, swelling of the lips, tongue or throat, dizziness or fainting, hives all over the body, or severe stomach pain with vomiting. Talk with a clinician or allergist soon about any sting reaction that spread beyond the sting site, even if this result is in the usual range.

Questions you could ask

  • Do I need to be tested for other stinging insects, such as yellow jacket or honey bee?
  • Does this result fit with what happened when I was stung?
  • Would a skin test or venom component tests help show which insect is involved?
  • Should we check my baseline tryptase level?
  • Do I need an emergency plan for future stings?
  • My result is in the usual range but I had a strong reaction to a sting. What should we do next?

Questions people ask

Does a positive paper wasp IgE mean I am allergic to wasp stings?

Not on its own. The test shows that your immune system has made IgE to paper wasp venom, which is called sensitization. One review found that many more adults are sensitized to insect venom (9.2 to 28.7%) than have had a whole-body sting reaction (0.3 to 7.5%). Your clinician reads the result with your sting history and, often, a skin test.

My paper wasp and yellow jacket results are both positive. Do I have two allergies?

Not necessarily. Paper wasp and yellow jacket venoms share proteins, and IgE made against one often binds the other. An allergist can use your sting history and extra tests to work out which insect is the likely cause, though these tests give only an estimate.

If my result is negative, can I rule out a venom allergy?

Not always. Some people with a clear history of a serious sting reaction have no detectable IgE to venom extracts. If you have had a reaction beyond the sting site, tell your clinician even when this result is negative.

Show the science and sources

For clinicians and researchers

Quantitative IgE to a Polistes spp. (paper wasp) venom extract (ImmunoCAP i4) by fluoroenzyme immunoassay. ARUP lists LOINC 6198-6. Mayo lists the test as Wasp Venom, IgE (alias Paper Wasp, Polistes spp.) with LOINC 13176-3. The ImmunoCAP Specific IgE system reports up to 100 kUA/L with a limit of quantitation of 0.1 kUA/L, and its maker recommends a 0.35 kUA/L cutoff while telling each lab to set its own range (FDA review K173726). Diagnosis of venom allergy rests on a history of a systemic sting reaction, a positive skin test and detection of venom-specific IgE. Positive results with whole-venom extracts do not always reflect clinically relevant sensitization, and some patients with a convincing history have negative tests (Ollert and Blank 2015). Paper wasp venoms show no immunologically detectable cross-reactive carbohydrate determinant reactivity, unlike honey bee and yellow jacket venoms, yet cross-reactivity between Polistinae and Vespinae (especially Vespula) venoms is frequent. Pol d 5 (antigen 5 of Polistes dominula) is available for routine molecular diagnostics, but comparing IgE to antigen 5 and phospholipase of Polistes and Vespula venoms gives only an estimate of the likely sensitizing venom. Mast cell disorders are over-represented in venom allergy: 20 to 39% of patients with mastocytosis have venom allergy, and reports suggest more severe sting reactions in people with mast cell disorders (Ollert and Blank 2015). Cutoffs and predictive values do not transfer between assay brands (NIAID 2010). Mayo notes false positives can occur above about 2,500 kU/L total IgE.

LOINC 6198-6 (primary), 13176-3. Specimen: serum.

Sources

  1. Allergen, Insects and Venom, Paper Wasp (ARUP test 0055048), ARUP Laboratories
  2. Wasp Venom, IgE, Serum (test ID WSPV), Mayo Clinic Laboratories
  3. 510(k) Decision Memorandum K173726: ImmunoCAP Specific IgE (ImmunoCAP Allergen f447, rAra h 6, Peanut), U.S. Food and Drug Administration (2018)
  4. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel, Journal of Allergy and Clinical Immunology (2010)
  5. Allergy Blood Test, MedlinePlus, National Library of Medicine
  6. Anaphylaxis to Insect Venom Allergens: Role of Molecular Diagnostics, Current Allergy and Asthma Reports (2015)

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

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