2014
DOI: 10.1177/0049475514525606
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Myocardial injury following multiple bee stings

Abstract: Envenomation by the honey bee can cause multi-organ dysfunction as a result of toxic effects and may cause a severe anaphylactic reaction. Acute myocardial ischemia is an extremely rare complication of bee envenomation. We report a case of a 58-year-old woman with acute myocardial injury following massive bee envenomation.

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Cited by 12 publications
(9 citation statements)
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“…[ 1 ] Cardiovascular events such as acute coronary syndrome and stroke can develop either secondary to anaphylaxis or as a delayed complication due to the direct toxin reactions. [ 1 5 ] During anaphylaxis, various biologic amines act as a vasoactive mediator causing peripheral vasodilatation and hence deep hypotension, while vasoconstricting effect on coronary circulation increases myocardial oxygen demand leading to myocardial ischemia. PLA2, a constituent of bee venom, activates the metabolism of the arachidonic acid resulting in release of leukotrienes by the lipoxygenase pathway and prostaglandins such as thromboxane by cyclooxygenase pathway.…”
Section: Discussionmentioning
confidence: 99%
“…[ 1 ] Cardiovascular events such as acute coronary syndrome and stroke can develop either secondary to anaphylaxis or as a delayed complication due to the direct toxin reactions. [ 1 5 ] During anaphylaxis, various biologic amines act as a vasoactive mediator causing peripheral vasodilatation and hence deep hypotension, while vasoconstricting effect on coronary circulation increases myocardial oxygen demand leading to myocardial ischemia. PLA2, a constituent of bee venom, activates the metabolism of the arachidonic acid resulting in release of leukotrienes by the lipoxygenase pathway and prostaglandins such as thromboxane by cyclooxygenase pathway.…”
Section: Discussionmentioning
confidence: 99%
“…Honeybee venom is composed of a mix of peptides, amines, and enzymes that include apamin (a small neurotoxin that blocks Ca 2+ dependent K + channels) 10 , adrenaline, noradrenaline, histamine, serotonin, and tertiapine, which may provoke myocardial ischemia and intense hypotension 11 . It could also be the cause of an allergic or non-allergic local reaction, anaphylaxis, or a systemic toxic reaction such as vomiting or edema 12 .…”
Section: Discussionmentioning
confidence: 99%
“…Early management of anaphylaxis with IM epinephrine (adrenaline), significantly reduces the complications, as they appear 48–72 h after the attack [ 2 – 4 , 6 , 7 , 12 ].…”
Section: Discussionmentioning
confidence: 99%
“…These manifestations are moderate to severe reactions [ 1 ]. Severe reaction cause multiorgan damage like acute kidney injury (AKI) and myocardial infarction [ 2 – 4 , 6 , 7 ]. AKI in children following multiple bee stings is uncommon complication in Africa and there is limited literature, especially in children.…”
Section: Introductionmentioning
confidence: 99%