PMID- 24962710
OWN - NLM
STAT- MEDLINE
DCOM- 20150828
LR  - 20211021
IS  - 1559-0267 (Electronic)
IS  - 1080-0549 (Linking)
VI  - 47
IP  - 1
DP  - 2014 Aug
TI  - Unusual reactions to hymenoptera stings: what should we keep in mind?
PG  - 91-9
LID - 10.1007/s12016-014-8434-y [doi]
AB  - This review includes a variety of extremely rare and unusual hymenoptera sting 
      (HS) circumstances with regard to sting localization, geographic region, 
      massivity of multiple stings, and particularly related to clinical symptoms. Such 
      reactions occur in a temporal relationship to HS (s), differ from typical 
      allergic symptomatology, and sometimes need follow-up during many months. With 
      respect to pathogenesis, the major mechanisms involved are toxic, autoimmune, and 
      other delayed immunological ones. While delayed inflammatory symptoms of the 
      nervous system are considered as delayed hypersensitization or autoimmune 
      entities, generalized rhabdomyolysis and consecutive acute kidney injury is 
      considered a toxic reaction, mostly induced by massive envenomation to wasps or 
      "Africanized" bees. Hemorrhagic episodes of targeted organ (s) could be 
      additional potential risk for acute kidney injury, while the bee venom-induced 
      hemorrhage is proposed to be a nonimmune-mediated anaphylactic symptom. The 
      hemodynamic involvement of vital organs and systems with hypoxia and hypovolemia 
      together with simultaneous immunoglobulin E (IgE) sensitization are considered 
      potential indications for venom immunotherapy. In contrast, patients who have 
      experienced various complications with unknown or nonallergic mechanisms should 
      be informed about the importance of epinephrine's use and additional measures on 
      future sting avoidance. In conclusion, although unusual reactions are extremely 
      rare, it is important to keep them in mind.
FAU - Mingomataj, Ervin C
AU  - Mingomataj EC
AD  - Department of Allergology and Clinical Immunology, "Mother Theresa" School of 
      Medicine, Tirana, Albania, allergology@gmx.de.
FAU - Bakiri, Alketa H
AU  - Bakiri AH
FAU - Ibranji, Alkerta
AU  - Ibranji A
FAU - Sturm, Gunter J
AU  - Sturm GJ
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Clin Rev Allergy Immunol
JT  - Clinical reviews in allergy & immunology
JID - 9504368
RN  - 0 (Venoms)
RN  - YKH834O4BH (Epinephrine)
SB  - IM
MH  - Animals
MH  - Autoimmunity
MH  - *Desensitization, Immunologic
MH  - Epinephrine/therapeutic use
MH  - Humans
MH  - Hymenoptera/*immunology
MH  - Hypersensitivity, Delayed/etiology/*immunology/prevention & control
MH  - Insect Bites and Stings/*immunology
MH  - Patient Education as Topic
MH  - Rhabdomyolysis/etiology/*immunology/prevention & control
MH  - Venoms/immunology
EDAT- 2014/06/26 06:00
MHDA- 2015/09/01 06:00
CRDT- 2014/06/26 06:00
PHST- 2014/06/26 06:00 [entrez]
PHST- 2014/06/26 06:00 [pubmed]
PHST- 2015/09/01 06:00 [medline]
AID - 10.1007/s12016-014-8434-y [doi]
PST - ppublish
SO  - Clin Rev Allergy Immunol. 2014 Aug;47(1):91-9. doi: 10.1007/s12016-014-8434-y.