Systemic Immediate Hypersensitive Reactions after Treatment with Sweet Bee Venom: A Case Report

Abstract

Objectives: A previous study showed that bee venom(BV) could cause anaphylaxis or other hypersensitivityreactions. Although hypersensitivity reactions dueto sweet bee venom (SBV) have been reported, SBVhas been reported to be associated with significantlyreduced sensitization compared to BV. Although nosystemic immediate hypersensitive response accompaniedby abnormal vital signs has been reported withrespect to SBV, we report a systemic immediate hypersensitiveresponse that we experienced while trying touse SBV clinically. Methods: The patient had undergone BV treatment severaltimes at other Oriental medicine clinics and hadexperienced no adverse reactions. She came to acupuncture& moxibustion department at Semyung universityhospital of Oriental medicine (Je-cheon, Korea)complaining of facial hypoesthesia and was treated usingSBV injections, her first SBV treatment. SBV, 0.05 cc,was injected at each of 8 acupoints, for a total of 0.40 cc:Jichang (ST4), Daeyeong (ST5), Hyeopgeo (ST6), Hagwan(ST7), Yepung (TE17), Imun (TE21), Cheonghoe(GB2), and Gwallyeo (SI18). Results: The patient showed systemic immediate hypersensitivereactions. The main symptoms were abdominal pain, nausea and perspiration, but common symptomsassociated with hypersensitivity, such as edema,were mild. Abdominal pain was the most long-lastingsymptom and was accompanied by nausea. Her bodytemperature decreased due to sweating. Her diastolicblood pressure could not be measured on threeoccasions. She remained alert, though the symptomspersisted. The following treatments were conductedin sequence; intramuscular epinephrine, 1 mg/mL,injection, intramuscular dexamethasone, 5 mg/mL,injection, intramuscular buscopan, 20 mg/mL, injection,oxygen (O2) inhalation therapy, 1 L/minutes, viaa nasal prong, and intravascular injection of normalsaline, 1 L. After 12 hours of treatment, the symptomshad completely disappeared. Conclusion: This case shows that the use of SBV doesnot completely eliminate the possibility of hypersensitivityand that patients who received BV treatmentbefore may also be sensitized to SBV. Thus, a skin testshould be given prior to using SBV.