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Published in: BMC Complementary Medicine and Therapies 1/2016

Open Access 01-12-2016 | Case report

Immune thrombocytopenia after bee venom therapy: a case report

Authors: Mohammad Adel Abdulsalam, Bader Esmael Ebrahim, Ahmad Jasem Abdulsalam

Published in: BMC Complementary Medicine and Therapies | Issue 1/2016

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Abstract

Background

Immune thrombocytopenia (ITP) is a hematological disorder with an isolated decrease in number of circulating platelets. Bee venom therapy (BVT) is a form of alternative medicine. It is still being practiced in the Middle East and other parts of Asia. In BVT, acupuncture points are used to inject diluted bee venom into the body. The pharmacological basis behind BVT is not fully understood. However, it has been used to treat various medical conditions such as arthritis and low back pain. On the other hand there have been a number of reported complications of BVT use such as ITP. We present a case report on ITP after BVT.

Case presentation

A 61 year old lady presented with gum bleeding and ecchymosis and found to have isolated thrombocytopenia (platelet count of 9 × 109/L) after receiving four direct bee sting sessions. There was no evidence of any other risk factors of ITP.

Conclusion

Bee venom components and toxicity may be associated with thrombocytopenia as a complication. Further research is needed to postulate guidelines and protocol for BVT. In the meantime, monitoring of the practice of BVT should be made, with an emphasis on patient education regarding the safety profile and associated risks compared to the gained benefits.
Literature
1.
go back to reference Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold D, Bussel J, Cines D, Chong B, Cooper N, Jodeau B, Lechner K, Mazzucconi M, McMillan R, Sanz M, Imbach P, Blanchette V, Kuhne T, Ruggeri M, George J. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009;113:2386–93.CrossRefPubMed Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold D, Bussel J, Cines D, Chong B, Cooper N, Jodeau B, Lechner K, Mazzucconi M, McMillan R, Sanz M, Imbach P, Blanchette V, Kuhne T, Ruggeri M, George J. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009;113:2386–93.CrossRefPubMed
2.
go back to reference Johnsen J. Pathogenesis in immune thrombocytopenia: new insights. Hematology Am Soc Hematol Educ Program. 2012;2012:306–12.PubMed Johnsen J. Pathogenesis in immune thrombocytopenia: new insights. Hematology Am Soc Hematol Educ Program. 2012;2012:306–12.PubMed
3.
go back to reference Cuker A, Cines DB. Immune thrombocytopenia. Hematology Am Soc Hematol Educ Program. 2010;2010:377–84.CrossRefPubMed Cuker A, Cines DB. Immune thrombocytopenia. Hematology Am Soc Hematol Educ Program. 2010;2010:377–84.CrossRefPubMed
4.
go back to reference Neylon A, Saunders P, Howard M, Proctor S, Taylor P. Clinically significant newly presenting autoimmune thrombocytopenic purpura in adults: a prospective study of a population-based cohort of 245 patients. Br J Haematol. 2003;122:966–74.CrossRefPubMed Neylon A, Saunders P, Howard M, Proctor S, Taylor P. Clinically significant newly presenting autoimmune thrombocytopenic purpura in adults: a prospective study of a population-based cohort of 245 patients. Br J Haematol. 2003;122:966–74.CrossRefPubMed
5.
go back to reference Frederiksen H, Schmidt K. The incidence of idiopathic thrombocytopenic purpura in adults increases with age. Blood. 1999;94:909–13.PubMed Frederiksen H, Schmidt K. The incidence of idiopathic thrombocytopenic purpura in adults increases with age. Blood. 1999;94:909–13.PubMed
6.
go back to reference Terrell D, Beebe L, Vesely S, Neas B, Segal J, George J. The incidence of immune thrombocytopenic purpura in children and adults: a critical review of published reports. Am J Hematol. 2010;85:174–80.CrossRefPubMed Terrell D, Beebe L, Vesely S, Neas B, Segal J, George J. The incidence of immune thrombocytopenic purpura in children and adults: a critical review of published reports. Am J Hematol. 2010;85:174–80.CrossRefPubMed
7.
go back to reference Chen J, Lariviere WR. The nociceptive and anti-nociceptive effects of bee venom injection and therapy: a double-edged sword. Prog Neurobiol. 2010;92(2):151–83.CrossRefPubMedPubMedCentral Chen J, Lariviere WR. The nociceptive and anti-nociceptive effects of bee venom injection and therapy: a double-edged sword. Prog Neurobiol. 2010;92(2):151–83.CrossRefPubMedPubMedCentral
8.
go back to reference Petroian G, Liu J, Helfrich U, Maleck W, Rufer R. Phospholipase &-induced coagulation abnormalities after bee sting. Am J Emerg Med. 2000;18:22–7.CrossRef Petroian G, Liu J, Helfrich U, Maleck W, Rufer R. Phospholipase &-induced coagulation abnormalities after bee sting. Am J Emerg Med. 2000;18:22–7.CrossRef
9.
go back to reference Chao Y, Yang A, Ng Y, Yang W. Acute interstitial nephritis and pigmented tubulopathy in a patient after wasp stings. Am J Kidney Dis. 2004;43:E6.CrossRef Chao Y, Yang A, Ng Y, Yang W. Acute interstitial nephritis and pigmented tubulopathy in a patient after wasp stings. Am J Kidney Dis. 2004;43:E6.CrossRef
10.
go back to reference Kumar V, Nada R, Kumar S, Ramachandran R, Rathi M, Kohli H, Sakhuga V, Jha V. Acute kidney injury due to acute cortical necrosis following a single wasp sting. Ren Fail. 2012;35(1):170–2.CrossRefPubMed Kumar V, Nada R, Kumar S, Ramachandran R, Rathi M, Kohli H, Sakhuga V, Jha V. Acute kidney injury due to acute cortical necrosis following a single wasp sting. Ren Fail. 2012;35(1):170–2.CrossRefPubMed
11.
12.
go back to reference Levine H. Acute myocardial infarction following wasp sting. Report of two cases and critical survey of the literature. Am Heart J. 1976;91:365–74.CrossRefPubMed Levine H. Acute myocardial infarction following wasp sting. Report of two cases and critical survey of the literature. Am Heart J. 1976;91:365–74.CrossRefPubMed
13.
go back to reference Mathew A, Chrispal A, David T. Acute myocardial injury and rhabdomyolysis caused by multiple bee stings. J Assoc Physicians India. 2011;59:518–20.PubMed Mathew A, Chrispal A, David T. Acute myocardial injury and rhabdomyolysis caused by multiple bee stings. J Assoc Physicians India. 2011;59:518–20.PubMed
14.
go back to reference Remes-Troche J, Téllez-Zenteno J, Rojas-Serrano J, Senties-Madrid H, Vega-Boada F, García-Ramos G. Thalamic and mesencephalic hemorrhages after multiple honeybee stings: a life threatening apitherapy complication. Eur Neurol. 2003;49(3):188–9.CrossRefPubMed Remes-Troche J, Téllez-Zenteno J, Rojas-Serrano J, Senties-Madrid H, Vega-Boada F, García-Ramos G. Thalamic and mesencephalic hemorrhages after multiple honeybee stings: a life threatening apitherapy complication. Eur Neurol. 2003;49(3):188–9.CrossRefPubMed
15.
go back to reference Viswanathan S, Muthu V, Singh AP, Rajendran R, George R. Middle cerebral artery infarct following multiple bee stings. J Stroke Cerebrovasc Dis. 2012;21(2):148–50.CrossRefPubMed Viswanathan S, Muthu V, Singh AP, Rajendran R, George R. Middle cerebral artery infarct following multiple bee stings. J Stroke Cerebrovasc Dis. 2012;21(2):148–50.CrossRefPubMed
16.
go back to reference Han-Min W, Feng L, Mei-Lan Z, Rong L, Hong-Bao L, Chen H, Peng Z. Successful treatment of multiple organ failure after wasp stings in an elderly patient. Int J Gerontol. 2012;6:52–3.CrossRef Han-Min W, Feng L, Mei-Lan Z, Rong L, Hong-Bao L, Chen H, Peng Z. Successful treatment of multiple organ failure after wasp stings in an elderly patient. Int J Gerontol. 2012;6:52–3.CrossRef
18.
go back to reference Tanphaichitr VS, Tuchinda M. Severe thrombocytopenic purpura following a bee sting. Ann Allergy. 1982;49(4):229–31.PubMed Tanphaichitr VS, Tuchinda M. Severe thrombocytopenic purpura following a bee sting. Ann Allergy. 1982;49(4):229–31.PubMed
19.
go back to reference Namdev R, Dutta SR, Singh H. Acute immune thrombocytopenic purpura triggered by insect bite. J Indian Soc Pedod Prev Dent. 2009;27(1):58–61.CrossRefPubMed Namdev R, Dutta SR, Singh H. Acute immune thrombocytopenic purpura triggered by insect bite. J Indian Soc Pedod Prev Dent. 2009;27(1):58–61.CrossRefPubMed
20.
go back to reference Akbayram S, Akgun C, Dogan M, Caksen H, Oner A. Acute ITP due to insect bite: report of 2 cases. Clin Appl Thromb Hemost. 2011;17(4):408–9.CrossRefPubMed Akbayram S, Akgun C, Dogan M, Caksen H, Oner A. Acute ITP due to insect bite: report of 2 cases. Clin Appl Thromb Hemost. 2011;17(4):408–9.CrossRefPubMed
22.
go back to reference Jung J, Jeon E, Kim J, Choi J, Shin J, Kim J, Park I, Choi B. A fatal case of intravascular coagulation after bee sting acupuncture. Allergy Asthma Immunol Res. 2012;4(2):107–9.CrossRefPubMedPubMedCentral Jung J, Jeon E, Kim J, Choi J, Shin J, Kim J, Park I, Choi B. A fatal case of intravascular coagulation after bee sting acupuncture. Allergy Asthma Immunol Res. 2012;4(2):107–9.CrossRefPubMedPubMedCentral
23.
go back to reference França FO, Benvenuti LA, Fan HW, Dos Santos DR, Hain SH, Picchi-Martins FR, Cardoso JL, Kamiguti AS, Theakston RD, Warrell DA. Severe and fatal mass attacks by ‘killer’ bees (Africanized honey bees--Apis mellifera scutellata) in Brazil: clinicopathological studies with measurement of serum venom concentrations. Q J Med. 1994;87:269–82.PubMed França FO, Benvenuti LA, Fan HW, Dos Santos DR, Hain SH, Picchi-Martins FR, Cardoso JL, Kamiguti AS, Theakston RD, Warrell DA. Severe and fatal mass attacks by ‘killer’ bees (Africanized honey bees--Apis mellifera scutellata) in Brazil: clinicopathological studies with measurement of serum venom concentrations. Q J Med. 1994;87:269–82.PubMed
24.
go back to reference Yuan Y, Jackson S, Newnham H, Mitchell C, Salem H. An essential role for lysophosphatidylcholine in the inhibition of platelet aggregation by secretory phospholipase A2. Blood. 1995;86(11):4166–74.PubMed Yuan Y, Jackson S, Newnham H, Mitchell C, Salem H. An essential role for lysophosphatidylcholine in the inhibition of platelet aggregation by secretory phospholipase A2. Blood. 1995;86(11):4166–74.PubMed
Metadata
Title
Immune thrombocytopenia after bee venom therapy: a case report
Authors
Mohammad Adel Abdulsalam
Bader Esmael Ebrahim
Ahmad Jasem Abdulsalam
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2016
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-016-1091-3

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