Anaphylactic shock with pulmonary eosinophilic infiltration due to honeybee attack in a donkey: case report / [Choque anafilático com infiltração eosinófila pulmonar devido a ataque de abelhas em um burro: relato de caso]

A case of a donkey attacked by Africanized honeybee is reported here with clinical signs of agitation, dehydration, congestion of the ocular mucous membranes, tongue edema, tachycardia and inspiratory dyspnea, and progression to death. At necropsy, diffuse, severe subcutaneous edema at face and cervical regions and severe diffuse pulmonary hyperemia with abundant edema without parenchymal collapse were observed. Microscopically, marked, diffuse deep dermis and panniculus carnosus edema and marked diffuse alveolar edema, with moderate population of eosinophils predominantly around larger caliber vessels were noted. The final diagnosis of anaphylactic shock was supported by history, clinical signs, and anatomic pathology findings. This is the first report of a honeybee attack with pulmonary eosinophilic infiltration in a mammal.(AU)

Descreve-se um caso de ataque de abelha africanizada em um burro, com sinais clínicos de agitação, desidratação, mucosas oculares congestas, edema de língua, taquicardia e dispneia inspiratória, com progressão e morte. Na necropsia, foram verificados edema subcutâneo difuso grave nas regiões de face e cervical, hiperemia pulmonar difusa grave com edema abundante e sem colapso do parênquima. Microscopicamente, foram observados edema marcado difuso na derme profunda e panículo carnoso e edema alveolar difuso acentuado, com população moderada de eosinófilos predominantemente em torno de vasos de maior calibre. O diagnóstico de choque anafilático foi baseado no histórico, em sinais clínicos e em achados anatomopatológicos. Este é o primeiro relato de ataque de abelhas com infiltração eosinofílica pulmonar em um mamífero.(AU)

Efecto antiinflamatorio de apitoxina de Apis mellifera sobre prostaglandina E2 del fluido crevicular gingival de pacientes con y sin enfermedad periodontal, sometidos a apiterapia: ensayo preliminar / Anti-inflammatory effect of apitoxin and Apis mellifera on prostaglandin E2 in gingival crevicular fluid of patients with and without periodontal disease, submitted to apitherapy: preliminary test

Introducción: La apitoxina que es producida por la Apis mellifera posee efecto antiinflamatorio sobre una serie de marcadores biológicos. La prostaglandina E2 forma parte de ellos, estando presente en el fluido gingival crevicular (FGC). La prostaglandina E2 es evidenciada en la enfermedad periodontal. Objetivo: En este estudio se evaluó el efecto antiinflamatorio de la apitoxina sobre la concentración de prostaglandina E2 del FGC de un paciente sin enfermedad periodontal (SEP) y otro con enfermedad periodontal (CEP). Materiales y Método: Se seleccionó un paciente SEP y otro CEP, que sometidos a apiterapia durante 28 días, se registraron 5 muestras por paciente de FGC, siendo almacenadas, centrifugadas y refrigeradas para su conservación. Posteriormente se midió la concentración de prostaglandina E2 crevicular mediante inmunodifusión radial simple en placas petri con concentración de anticuerpo anti prostaglandina E2 de 1:1000. Selladas a 4°C, se esperó 72 horas para permitir su difusión, tiñéndose con Azul brillante de Coomasie, determinándose la concentración de cada placa. Resultados: Paciente SEP inmediatamente antes de apiterapia presentó una concentración de 0.9636 ± 0.0055 (ug/uL), finalizando con una concentración de 0.9196+/-0.0733 (ug/uL) al completar 28 días de tratamiento. El paciente CEP antes de recibir apiterapia presento una concentración de 1.1866 +/- 0.0867 (ug/uL), finalizando con una concentración de 0.9858 +/- 0.0074 (ug/uL) al completar 28 días de tratamiento. Discusión: Los hallazgos de este estudio demuestran una disminución de la concentración de PGE2 del FGC tanto para el paciente CEP y SEP sometidos a apiterapia durante 28 días, siendo esta disminución 3.7 veces mayor en el paciente CEP.

Introduction: Apitoxin, which is produced by Apis mellifera, has anti-inflammatory effect on a number of biomarkers. Prostaglandin E2 is one of them, being present in gingival crevicular fluid (GCF). Prostaglandin E2 is evidenced in periodontal disease. Objective: This study evaluated the antiinflammatory effect of apitoxin on concentration of prostaglandin E2 FGC in a patient with no periodontal disease (SEP) and other with periodontal disease (CEP). Materials and Methods: We selected both a SEP and CEP patient who were subjected to apitherapy for 28 days. There were 5 samples per patient of FGC, being stored, centrifuged and refrigerated for their preservation. Subsequently, the concentrations of crevicular prostaglandin E2 were measured by simple radial immunodiffusion in petri dishes with antibody concentration of prostaglandin E2 of 1:1000. Sealed at 4 °C, after 72 hours to allow diffusion, they were stained with Coomassie Brilliant Blue, determining the concentration of each plate. Results: SEP patient immediately before apitherapy presented a concentration of 0.9636 +/- 0.0055 (g / mL), ending with a concentration of 0.9196 +/- 0.0733 (g / mL) upon completion of 28 days of treatment. CEP patient before receiving apitherapy showed a concentration of 1.1866 +/- 0.0867 (g/mL), ending with a concentration of 0.9858 +/- 0.0074 (g/mL) upon completion of 28 days of treatment. Discussion: The findings of this study show a decrease in the concentration of PGE2 of FGC both for the CEP and SEP patient subjected to apitherapy for 28 days, being this decrease 3.7 times higher in the CEP patient.

Foreign Body Granuloma Following Dried Honey Bee Venom (Apitoxin Inj) Injection / 대한피부과학회지

Bee sting therapy is sometimes used for the treatment of chronic recalcitrant neuralgia and arthralgia in traditional Korean herbal medicine, but retained sting materials at the treatment site may induce granulomatous inflammation. Recently, dried honey bee venom (Apitoxin Inj, Guju Pharma. Co., Seoul, Korea) has been approved by the Korea Food and Drug Administration (KFDA) as an anti-inflammatory drug. The adverse events associated with dried honey bee venom injection include itching, edema, pain, headache, fever and myalgia, but foreign body granuloma caused by drug injection has not been previously reported. We herein report two interesting cases of foreign body granuloma induced by dried honey bee venom injection.

Minimal Change Nephrotic Syndrome After Apitoxin Therapy: A Case Report / 대한신장학회지

Bee stings have previously been implicated in the development of nephrotic syndrome, but the reported cases in the literature are rare. Furthermore, there has been no case of nephrotic syndrome after bee venom (apitoxin) therapy. We experienced a 28-year-old female who developed generalized edema 6 days after an intramuscular injection of apitoxin. The physical examination and laboratory findings were relevant with nephrotic syndrome and the renal biopsy revealed minimal change nephrotic syndrome. The corticosteroid treatment induced prompt remission with resolution of edema and normalization of the laboratory findings. There was no relapse of the disease during the 6-month follow-up. We report this case together with brief review of literatures.