RESUMO
RESUMO O propósito deste estudo foi reportar as alterações oculares observadas após picada de abelha com ferrão retido na córnea. Destacamos o tratamento e o desfecho de uma lesão de córnea incomum e sua patogênese. Trata-se de relato de caso e revisão da literatura de lesões oculares por picada de abelha. Paciente do sexo feminino, 63 anos, procurou atendimento oftalmológico de urgência devido à picada de abelha na córnea do olho direito há 6 dias. Queixava-se de embaçamento visual, dor e hiperemia ocular. Apresentou acuidade visual de vultos no olho afetado. Ao exame, notaram-se hiperemia moderada de conjuntiva bulbar, edema corneano com dobras de Descemet e presença do ferrão alojado na região temporal, no estroma profundo da córnea. A paciente foi internada para ser abordada no centro cirúrgico sob anestesia geral. Durante a cirurgia, o ferrão teve que ser retirado via câmara anterior, mediante a realização de uma paracentese e uma lavagem da câmara anterior, com dupla via e solução salina balanceada. Ainda não existe na literatura um tratamento padrão na abordagem de pacientes com lesões oculares por picada de abelha, sendo importantes a identificação e o reconhecimento precoce de possíveis complicações que ameacem a visão.
ABSTRACT The purpose of this study was to report the ocular changes observed after a bee sting with a stinger retained in the cornea. We show the treatment and outcome of an unusual corneal injury and its pathogenesis. This is a case report and literature review of ocular injuries caused by bee stings. A 63-year-old female patient sought emergency ophthalmic care because of a bee sting on the cornea of her right eye six days before. She complained of blurred vision, pain, and ocular hyperemia. She had glare sensitivity on visual acuity in the affected eye. Examination revealed moderate hyperemia of the bulbar conjunctiva, corneal edema with Descemet's folds and a stinger lodged in the temporal region, in the deep stroma of the cornea. The patient was admitted to the operating room under general anesthesia. During surgery, the stinger had to be removed via the anterior chamber, by performing a paracentesis and washing the anterior chamber with a double flushing and balanced saline solution. There is still no standard treatment in the literature for patients with eye injuries caused by bee stings, and early identification and recognition of possible sight-threatening complications is important.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Venenos de Abelha/efeitos adversos , Edema da Córnea/etiologia , Corpos Estranhos no Olho/complicações , Lesões da Córnea/etiologia , Mordeduras e Picadas de Insetos/complicações , Procedimentos Cirúrgicos Oftalmológicos/métodos , Edema da Córnea/diagnóstico , Edema da Córnea/fisiopatologia , Iridociclite , Corpos Estranhos no Olho/cirurgia , Corpos Estranhos no Olho/diagnóstico , Lesões da Córnea/cirurgia , Lesões da Córnea/diagnóstico , Microscopia com Lâmpada de Fenda , Gonioscopia , Mordeduras e Picadas de Insetos/cirurgia , Mordeduras e Picadas de Insetos/diagnósticoRESUMO
BACKGROUND: Beekeepers are exposed to frequent honey-bee stings, and have the risk to develop hypersensitivity to bee venom, but long-term exposure can induce immune tolerance in them. Up to 30% of beekeepers show positive skin tests with honey-bee venom. The prevalence of systemic reactions to bee stings in beekeepers is from 14% to 42%. OBJECTIVE: To know the prevalence of hypersensitivity to honeybee venom in Mexican beekeepers and non-beekeepers by the use of skin tests. MATERIAL AND METHODS: A group of 139 beekeepers and a group of 60 non-beekeeper volunteers had a history and physical related to age, sex, family and personal atopic history and time of exposure to bee stings. Both groups received intradermal skin tests with honey-bee venom, 0.1 mcg/mL and 1 mcg/mL, and histamine sulphate 0.1 mg/mL and Evans solution as controls. The skin tests results of both groups were compared by chi-squared test. RESULTS: Of the group of beekeepers, 116 were men (83%) and 23 women, average age was 39.3 years, had atopic family history 28% and personal atopy 13%, average time of exposure to bee stings was 10.9 years, skin tests with honey-bee venom were positive in 16.5% and 11% at 1 mcg/mL and 0.1 mcg/mL, respectively. In the non-beekeepers group venom skin tests were positive in 13.3% and 6.7% at 1 mcg/mL and 0.1 mcg/mL. We did not find significant differences between the two venom concentrations tested in both groups, neither in the number of positive skin tests between the two groups. CONCLUSIONS: We found hypersensivity to honey-bee venom slightly higher in the beekeepers than in the group apparently not exposed. Both honey-bee venom concentrations used did not show difference in the results of the skin tests. The similarity of skin tests positivity between both groups could be explained by immune tolerance due to continued exposure of beekeepers.
ANTECEDENTES: los apicultores están expuestos frecuentemente a picaduras de abejas y tienen el riesgo de volverse hipersensibles al veneno de abejas, pero la exposición a largo plazo puede inducir tolerancia inmunológica. Hasta 30% de los apicultores tienen pruebas cutáneas positivas con veneno de abeja. La prevalencia de reacciones sistémicas por picaduras de abejas en los apicultores es de 14 a 42%. OBJETIVO: conocer la prevalencia de hipersensibilidad al veneno de abeja en apicultores mexicanos y no apicultores, mediante la aplicación de pruebas cutáneas. MATERIAL Y MÉTODOS: estudio transversal que se incluyeron 139 apicultores y 60 voluntarios no apicultores se les elaboró su historia clínica con referencia a la edad, sexo, antecedentes familiares y personales atópicos y tiempo de exposición a picaduras de abejas. A los dos grupos se les aplicaron pruebas cutáneas intradérmicas con veneno de abeja con 0.1 y 1 mcg/mL, y como testigos sulfato de histamina 0.1 mg/mL y solución de Evans. Los resultados de las pruebas cutáneas se compararon entre los dos grupos mediante chi cuadrada. RESULTADOS: del grupo de apicultores 116 fueron hombres (83%) y 23 mujeres, la edad promedio fue de 39.3 años; refirieron atopia familiar 28% y atopia personal 13%; el tiempo de exposición promedio a picaduras de abejas fue de 10.9 años; las pruebas cutáneas con veneno de abeja fueron positivas en 16.5 y 11% a concentraciones de 1 y 0.1 mcg/mL, respectivamente. En el grupo de no apicultores las pruebas cutáneas con veneno resultaron positivas en 13.3 y 6.7% a concentraciones de 1 y 0.1 mcg/mL, respectivamente. No se observaron diferencias significativas entre las dos concentraciones de veneno probadas en ambos grupos, ni en el número de pruebas cutáneas positivas entre los dos grupos. CONCLUSIONES: se encontró hipersensibilidad al veneno de abeja ligeramente mayor en los apicultores que en el grupo aparentemente no expuesto. Las dos concentraciones de veneno de abeja probadas no mostraron diferencia en los resultados de las pruebas cutáneas.
Assuntos
Alérgenos/efeitos adversos , Venenos de Abelha/efeitos adversos , Criação de Abelhas , Abelhas/imunologia , Hipersensibilidade Imediata/etiologia , Doenças Profissionais/etiologia , Adulto , Alérgenos/farmacologia , Animais , Especificidade de Anticorpos , Venenos de Abelha/farmacologia , Estudos Transversais , Relação Dose-Resposta Imunológica , Feminino , Liberação de Histamina/efeitos dos fármacos , Humanos , Hipersensibilidade Imediata/epidemiologia , Hipersensibilidade Imediata/imunologia , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Mordeduras e Picadas de Insetos/imunologia , Testes Intradérmicos , Masculino , México/epidemiologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/imunologia , PrevalênciaRESUMO
O veneno de abelhas (BV, do inglês beevenom), vem sendo usado com propósitos terapêuticos tanto em medicina humana quanto em medicina veterinária. A apipuntura é uma prática terapêutica da acupuntura, onde o veneno de abelhas é injetado empontos de acupuntura, através do próprio ferrão do inseto na pele ou de aplicação de injeções de veneno diluído. Apesar dos efeitos promissores do BV, o potencial tóxico do veneno de abelhas deve ser considerado. O objetivo deste estudo foi monitorar os possíveis efeitos tóxicos e a resposta cutânea local induzida pela injeção de doses diluídas em cães Beagles sadios. A resposta cutânea local foi mensurada através da distensão tecidual relativa onde a distensão da orelha esquerda, injetada com 0,1 ml de uma solução de BV diluído em salina nas doses de 0,3mg/kg (n=4), 0,043mg/kg (n=4) de BV/animal ou de salina (grupo controle, n=4) foi comparada com a distensão da orelha direita injetada com salina. A distensão tecidual relativa foi analisada nos tempos 5, 10, 15, 30 minutos, 1, 6, 12, 24, 48 e 72 horas pós inoculação do veneno. As alterações clínicas como freqüência cardíaca e respiratória, pressão arterial e temperatura; assim como as reações comportamentais; os perfis hematológico (hemograma) e renal (uréia, creatinina) e foram monitorados em diferentes tempos após a inoculação. O pico de distensão tecidual relativa ocorreu 6 horas após a inoculação do veneno, sendo a dose de 0,3mg/kg capaz de produzir distensão diferente do controle-salina nos tempos 1, 6 e 12 horas após inoculação. Não foram detectadas diferenças siginificativas entre os grupos nos demais parâmetros analisados. Estes resultados indicam que o veneno de abelhas em cães produz um pico dereação cutânea local 6 horas após a inoculação e que as doses de 0,3mg/kg e 0,043mg/kg não produzem alterações comportamentais ou autonômicas significaticas além de não produzir nefrotoxidade ou alterações no perfil hematológico de cães.
The bee venom (BV) has been used for therapeutic purposes in both human medicine and veterinary medicine. The apipuncture is a therapeutic practice of acupuncture, where the bee venom is injected into acupuncture points, by their own insect's sting into the skin or injections of diluted venom. Despite the promising effects of BV, the toxic and allergenic potential of bee venom should be considered. The aim of this study was to check the possible toxic effects and local cutaneous reaction of the injection of diluted doses in healthy dogs Beagles. The local cutaneous reaction was measured by relative tissue distension on where the distension of the left ear (injected with 0.1 ml of a solution BV diluted with saline in the doses of 0.3 mg / kg (n = 4), 0.043 mg / kg (n= 4) BV / animal or saline (control group, n = 4) was compared with the distension of the right ear, injected with saline. The tissue distension was analyzed on the times of 5, 10, 15, 30 minutes, 1, 6, 12, 24, 48 and 72 hours post inoculation. Clinical changes such as heart rate and respiratory rate, blood pressure and temperature as well as behavioral responses, the profiles hematologic (blood) and kidney (urea, creatinine and urinalysis) were monitored at different times after inoculation. The peak of tissue distension occurred 6 hours after venom inoculation and the dose of 0.3 mg/kg producedsignificant higher distension than the saline-control group one, 6 and 12 hours after inoculation. No siginicant differences were found between groups for the other parameters. These results indicate that the bee venom in dogs produced a peak of cutaneous distension 6 hours after inoculation and that the dosis of 0.3 mg / kg and 0.043 mg / kg did not produced significant behavioral or autonomic changes and did not produced nephrotoxicity or hematological changes in dogs.
Assuntos
Animais , Cães , Venenos de Abelha/análise , Venenos de Abelha/efeitos adversos , Venenos de Abelha/químicaRESUMO
Nearly half of Hymenoptera stings affect the head and neck region of victims, but reports on oropharyngeal bee stings are very few. We describe the case of a patient with odynophagia and suffocation in mass envenomation. He had a retained bee stinger whose removal was delayed for more than 24 hours following the sting, due to persisting angioedema. Odynophagia receded after removal of the stinger and treatment with paracetamol, steroids and metronidazole. The patient also developed rhabdomyolysis, renal failure and hepatitis that were treated with conservative therapy. Oropharyngeal stings can simulate symptoms of persisting angioedema in victims of mass envenomation.(AU)
Assuntos
Humanos , Venenos de Abelha/efeitos adversos , Orofaringe/lesões , Orofaringe/patologia , HimenópterosRESUMO
Stings by bees and wasps, including Brazilian species, are a severe public health problem. The local reactions observed after the envenoming includes typical inflammatory response and pain. Several studies have been performed to identify the substances, including peptides that are responsible for such phenomena. The aim of the present study is to characterize the possible nociceptive (hyperalgesic) and edematogenic effects of some peptides isolated from the venoms of the honeybee (Apis mellifera) and the social wasps Polybia paulista and Protonectarina sylveirae, in addition to characterize some of the mechanisms involved in these phenomena. For this purpose, different doses of the peptides mellitin (Apis mellifera), Polybia-MP-I, N-2-Polybia-MP-I (Polybia paulista), Protonectarina-MP-NH2 and Protonectarina-MP-OH (Protonectarina sylveirae) were injected into the hind paw of mice. Hyperalgesia and edema were determined after peptide application, by using an electronic von Frey apparatus and a paquimeter. Carrageenin and saline were used as controls. Results showed that melittin, Polybia-MP-I, N-2-Polybia-MP-I, Protonectarina-MP-NH(2) and Protonectarina-MP-OH peptides produced a dose- and time-related hyperalgesic and edematogenic responses. Both phenomena are detected 2 h after melittin, Polybia-MP-I, N-2-Polybia-MP-I injection; their effects lasted until 8 h. In order to evaluate the role of prostanoids and the involvement of lipidic mediators in hyperalgesia induced by the peptides, indomethacin and zileuton were used. Results showed that zileuton blocked peptide-induced hyperalgesia and induced a decrease of the edematogenic response. On the other hand, indomethacin did not interfere with these phenomena. These results indicate that melittin, Polybia-MP-I, N-2-Polybia-MP-I, Protonectarina-MP-NH(2), and Protonectarina-MP-OH peptides could contribute to inflammation and pain induced by insect venoms.
Assuntos
Venenos de Abelha/efeitos adversos , Abelhas/química , Mordeduras e Picadas/induzido quimicamente , Edema/induzido quimicamente , Hiperalgesia/induzido quimicamente , Venenos de Vespas/efeitos adversos , Animais , Venenos de Abelha/imunologia , Venenos de Abelha/isolamento & purificação , Mordeduras e Picadas/imunologia , Edema/imunologia , Humanos , Hiperalgesia/imunologia , Masculino , Camundongos , Dor/induzido quimicamente , Dor/imunologia , Venenos de Vespas/imunologia , Venenos de Vespas/isolamento & purificação , Vespas/químicaRESUMO
OBJECTIVE: to review the main features about honey-bee venom desensitization in patients with adverse reactions to honey-bee stings. METHOD: a non-systematic search was performed in the main internet medical data base looking for relevant papers related to honeybee venom allergy, patients' selection for honey-bee venom immunotherapy (HBVIT), the most effective immunotherapy, the time of application and the protection obtained by HBVIT. RESULTS: of a total of 1,656 articles found, 18 documents were selected and revised, with the following findings: the HBVIT is indicated in patients with a clinical history and diagnostic confirmatory tests of allergy to bee venom and with the knowledge of the natural history of the disease. The protection against systemic reactions caused by new bee stings using HBVIT is over 90%. It is advisible to apply HBVIT for continuos periods of 5 years in order to develop a long-lasting immunologic tolerance. CONCLUSIONS: HBVIT has well defined clinical indications, and its adequate application offers protection in the long term against new bee stings.
Assuntos
Venenos de Abelha/efeitos adversos , Venenos de Abelha/imunologia , Dessensibilização Imunológica , Hipersensibilidade/imunologia , Hipersensibilidade/terapia , HumanosRESUMO
Bee stings of the eye are uncommon entities and ocular reactions to the bee venom are wide, ranging from mild conjunctivitis to sudden vision loss. We present the case of a patient who suffered a bee sting of the cornea and the response to the poison components. We go through the bee venom properties, its actual treatment, and propose a new management alternative.
Las picaduras de abeja en el ojo son entidades poco comunes y las reacciones oculares al veneno de abeja son amplias, pues van desde una leve conjuntivitis hasta la pérdida aguda de la visión. Se presenta el caso de un paciente que sufrió la picadura de una abeja en la córnea y la respuesta frente a los componentes de este veneno. Se realizó una revisión de las propiedades del veneno de abeja, su tratamiento actual y se propone una nueva alternativa de manejo.
Assuntos
Abelhas , Córnea , Mordeduras e Picadas/complicações , Venenos de Abelha/efeitos adversosRESUMO
Hymenoptera order includes bees, which have a stinging apparatus at the tail capable of delivering venom to the affected tissues. Myocardial infarction, acute renal failure, Necrotizing fasciitis, fatal infection and hemifacial asymmetry, are some of the unusual reactions reported following hymenoptera stings. This paper reports a case of bee sting in the right floor of the nose that mimicked an odontogenic infection affecting the upper lip, canine space and nasal cavity such as in cases of infection secondary to pulpal or periodontal pathology of the anterior teeth. After a thorough clinical and radiographic examination, odontogenic infection was discarded and the diagnosis of floor of the nose mucosal lysis and lip abscess secondary to a bee sting was made. This case was successfully managed with adequate incision, drainage and antibiotics without any further complication. There are several reports of unusual reactions following hymenoptera stings. However, just a few of them referred to infections of local reactions and none of them related to the anatomic location affected in the patient of the present case. Early diagnosis and treatment prevented infection dissemination and the likelihood of tissue necrosis as in previously reported cases of Necrotizing fasciitis.
Assuntos
Abscesso/patologia , Fístula Dentária/patologia , Mordeduras e Picadas de Insetos/complicações , Doenças Labiais/patologia , Mucosa Nasal/patologia , Abscesso/etiologia , Abscesso/terapia , Adulto , Animais , Venenos de Abelha/efeitos adversos , Abelhas , Desbridamento , Fístula Dentária/etiologia , Fístula Dentária/terapia , Diagnóstico Diferencial , Drenagem , Humanos , Doenças Labiais/etiologia , Doenças Labiais/terapia , Masculino , Doenças Dentárias/patologia , Resultado do TratamentoRESUMO
Hymenoptera order includes bees, which have a stinging apparatus at the tail capable of delivering venom to the affected tissues. Myocardial infarction, acute renal failure, Necrotizing fasciitis, fatal infection and hemifacial asymmetry, are some of the unusual reactions reported following hymenoptera stings. This paper reports a case of bee sting in the right floor of the nose that mimicked an odontogenic infection affecting the upper lip, canine space and nasal cavity such as in cases of infection secondary to pulpal or periodontal pathology of the anterior teeth. After a thorough clinical and radiographic examination, odontogenic infection was discarded and the diagnosis of floor of the nose mucosal lysis and lip abscess secondary to a bee sting was made. This case was successfully managed with adequate incision, drainage and antibiotics without any further complication. There are several reports of unusual reactions following hymenoptera stings. However, just a few of them referred to infections of local reactions and none of them related to the anatomic location affected in the patient of the present case. Early diagnosis and treatment prevented infection dissemination and the likelihood of tissue necrosis as in previously reported cases of Necrotizing fasciitis.
A ordem das himenópteras inclui abelhas, que possuem um ferrão na cauda capaz de de injetar veneno nos tecidos afetados. Fasciite necrosante, infecção fatal e assimetria hemifacial são algumas das reações incomuns relatadas após picada de himenópteras. Este estudo relata um caso de picada de abelha no assoalho da narina direita que simulou uma infecção odontogênica atingindo o lábio superior, o espaço canino e a cavidade nasal, como observado nos casos de infecção secundária após patologia pulpar ou periodontal dos dentes anteriores. Após completo exame clínico e radiográfico, foi descartada a hipótese de infecção odontogênica e foi estabelecido o diagnóstico de lise da mucosa do assoalho da narina e abscesso do lábio, após picada de abelha. Este caso foi tratado com sucesso com adequada incisão, drenagem e administração de antibióticos, sem outras complicações. Há vários relatos de reações incomuns resultantes de picada de himenópteras, porém poucos são relativos a infecções locais e nenhum se refere à localização anatômica afetada no paciente do caso aqui relatado. Diagnóstico e tratamento precoces preveniram a disseminação da infecção e a possibilidade de necrose tecidual, como já relatado em casos de fasciite necrosante.
Assuntos
Adulto , Animais , Humanos , Masculino , Abscesso/patologia , Fístula Dentária/patologia , Mordeduras e Picadas de Insetos/complicações , Doenças Labiais/patologia , Mucosa Nasal/patologia , Abscesso/etiologia , Abscesso/terapia , Abelhas , Venenos de Abelha/efeitos adversos , Desbridamento , Diagnóstico Diferencial , Drenagem , Fístula Dentária/etiologia , Fístula Dentária/terapia , Doenças Labiais/etiologia , Doenças Labiais/terapia , Resultado do Tratamento , Doenças Dentárias/patologiaRESUMO
Background: Immunotherapy can be used to treat allergic reactions to insect stings, specially bees and wasps. Aim: To report the experience with immunotherapy with aqueous extracts of hymenoptera venoms (bees and wasps). Material and methods: Ten patients aged 6 to 58 years were treated in an allergy center of a University Clinical Hospital. The medical indication for this treatment was, in all patients, anaphylactic reactions after hymenoptera stings. Immunotherapy was carried out using standardized vaccines (Aqueous extracts Venomvac LETI, Spain), applied in a traditional protocol, with subcutaneous injections. This protocol had two phases: a buildup phase (between weeks 1 and 13) and a monthly maintenance phase, from the 13th week. The monthly maintenance dose was 100 fig of hymenoptera specific venom extract. Results: Six patients had adverse reactions of different severity, during the treatment protocols and all had a good response to immediate therapeutic measures. After these events, they followed the protocol without problems. Two patients, treated with bee vaccines, suffered an accidental bee sting during the maintenance phase and they developed only local reactions. Conclusions: The lack of adverse reactions to bee stings in these two patients indicates the acquisition of clinical tolerance.
Assuntos
Adolescente , Adulto , Animais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Venenos de Abelha/uso terapêutico , Dessensibilização Imunológica/métodos , Himenópteros/imunologia , Hipersensibilidade Imediata/terapia , Mordeduras e Picadas de Insetos/terapia , Venenos de Vespas/uso terapêutico , Anafilaxia/terapia , Venenos de Abelha/efeitos adversos , Venenos de Abelha/imunologia , Hipersensibilidade Imediata/imunologia , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/imunologia , Venenos de Vespas/efeitos adversos , Venenos de Vespas/imunologiaRESUMO
BACKGROUND: The reported prevalence of allergic systemic reactions to hymenoptera venom occur in up to 3.3% and large local reactions occur in 17% in the general population. OBJECTIVE: To investigate the prevalence of hymenoptera sting allergy in a group of veterinary medicine students from Monterrey, Nuevo Leon, Mexico. PARTICIPANTS AND METHODS: A transverse and observational study was done with 64 students of veterinary medicine. We conducted a questionnaire about the students' history of insect allergy and atopy. Skin test with allergenic extracts of bee and ant were practiced to all subjects. We performed aeroallergen skin prick test to the subjets with suspected atopy. RESULTS: Students age ranged from 17 to 25 years (mean 20.2) and 37 were males. Twenty students (31.3%) had clinical history of atopy and positive skin tests to aeroallergens. On the other hand, 5 students (7.8%), including 2 atopic, had suffered large local reactions, but none of them had suffered systemic reactions. Bee and ant skin tests were positive in 15.6% and 31.3% of the students respectively. There was no difference in the prevalence of hymenoptera allergy between atopic and non atopic subjects (p < 0.05). Further, the frequency of atopy in subjects with positive skin tests for bee and ant was 50%. CONCLUSION: The prevalence of large local reactions and hymenoptera sensitization found in this group was similar to that found in other epidemiologic studies.
Assuntos
Venenos de Formiga/efeitos adversos , Venenos de Abelha/efeitos adversos , Hipersensibilidade Imediata/epidemiologia , Mordeduras e Picadas de Insetos/imunologia , Estudantes de Ciências da Saúde , Medicina Veterinária , Adolescente , Adulto , Comorbidade , Feminino , Humanos , Hipersensibilidade Imediata/diagnóstico , Hipersensibilidade Imediata/etiologia , Masculino , México/epidemiologia , Prevalência , Recidiva , Hipersensibilidade Respiratória/epidemiologia , Testes Cutâneos , Estudantes de Ciências da Saúde/estatística & dados numéricos , Venenos de Vespas/efeitos adversosRESUMO
BACKGROUND: Immunotherapy can be used to treat allergic reactions to insect stings, specially bees and wasps. AIM: To report the experience with immunotherapy with aqueous extracts of hymenoptera venoms (bees and wasps). MATERIAL AND METHODS: Ten patients aged 6 to 58 years were treated in an allergy center of a University Clinical Hospital. The medical indication for this treatment was, in all patients, anaphylactic reactions after hymenoptera stings. Immunotherapy was carried out using standardized vaccines (Aqueous extracts Venomvac LETI, Spain), applied in a traditional protocol, with subcutaneous injections. This protocol had two phases: a buildup phase (between weeks 1 and 13) and a monthly maintenance phase, from the 13th week. The monthly maintenance dose was 100 fig of hymenoptera specific venom extract. RESULTS: Six patients had adverse reactions of different severity, during the treatment protocols and all had a good response to immediate therapeutic measures. After these events, they followed the protocol without problems. Two patients, treated with bee vaccines, suffered an accidental bee sting during the maintenance phase and they developed only local reactions. CONCLUSIONS: The lack of adverse reactions to bee stings in these two patients indicates the acquisition of clinical tolerance.
Assuntos
Venenos de Abelha/uso terapêutico , Dessensibilização Imunológica/métodos , Himenópteros/imunologia , Hipersensibilidade Imediata/terapia , Mordeduras e Picadas de Insetos/terapia , Venenos de Vespas/uso terapêutico , Adolescente , Adulto , Anafilaxia/terapia , Animais , Venenos de Abelha/efeitos adversos , Venenos de Abelha/imunologia , Criança , Feminino , Humanos , Hipersensibilidade Imediata/imunologia , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/imunologia , Masculino , Pessoa de Meia-Idade , Venenos de Vespas/efeitos adversos , Venenos de Vespas/imunologiaRESUMO
Under the heading of this subject we deal with stings by arthropods, making of bees, commenting on the composition of the poisons and the different local and general reactions that are differences that exist between the stings The venom contains many biologically active components such as melitin, phospholipase A2, apamin, mast cell degranulation peptide, hyaluronidase, histamine, and dopamine. That neurotoxic venom secretory phospholipases A2 (sPLA2) have specific receptors in brain membranes called N-type receptors that are likely to play a role in the molecular events leading to neurotoxicity of these proteins. The sPLA2 found in honeybee venom is neurotoxic and binds to this receptor with high affinity. Poneratoxin is small neuropeptide found in the venom of arthropod (bee). It is stored in the venom reservoir as a inactive 25 residue peptide. Here we describe both chemically synthesized poneratoxin, insect larvae were paralyzed by injection of either of the purified toxins. These toxins are used in research as molecular probes, targeting with high affinity selected ion channel subtypes. As such, they are very useful for understanding the mechanism of synaptic transmission. Poneratoxin affects the voltage-dependent sodium channels and blocks the synaptic transmission in the insect central nervous system in a concentration-dependent manner; we think that in the human this is same.
Assuntos
Anafilaxia/induzido quimicamente , Venenos de Abelha/efeitos adversos , Abelhas , Hipersensibilidade/etiologia , Mordeduras e Picadas de Insetos/complicações , Síndromes Neurotóxicas/diagnóstico , Síndromes Neurotóxicas/etiologia , Animais , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Intoxicação/diagnóstico , Intoxicação/classificação , Intoxicação/complicações , Intoxicação/etiologia , Intoxicação/patologia , Intoxicação/terapia , Substâncias Tóxicas , Praguicidas/classificação , Praguicidas/efeitos adversos , Aspirina/intoxicação , Anfetaminas/intoxicação , Antibacterianos/intoxicação , Antagonistas dos Receptores Histamínicos H1/intoxicação , Benzodiazepinas/intoxicação , Antagonistas Adrenérgicos beta/intoxicação , Carbamazepina/intoxicação , Ranitidina/intoxicação , Clormezanona/intoxicação , Dissulfiram/intoxicação , Fenitoína/intoxicação , Fenobarbital/intoxicação , Fluoxetina/intoxicação , Ibuprofeno/intoxicação , Lítio/intoxicação , Glucosídeos/intoxicação , Dipirona/intoxicação , Nifedipino/intoxicação , Entorpecentes/intoxicação , /intoxicação , Antidepressivos Tricíclicos/intoxicação , Fenotiazinas/intoxicação , Acetaminofen/intoxicação , Solventes/intoxicação , Álcoois/intoxicação , Parafina/intoxicação , Tetracloroetileno/intoxicação , Xilenos/intoxicação , Gás Tóxico , Gás Tóxico , Produtos Domésticos/intoxicação , Plantas/intoxicação , Venenos de Aranha/efeitos adversos , Venenos de Abelha/efeitos adversos , Venenos de Escorpião/efeitos adversos , Metais Pesados , Drogas Ilícitas/intoxicação , Cocaína/intoxicação , Abuso de Maconha/complicações , Transtornos Relacionados ao Uso de SubstânciasRESUMO
Introducción. La picadura masiva de abejas desencadena graves efectos tóxicos por la cantidad de veneno transmitido. Se reporta un caso en un niño mexicano haciendo énfasis en las complicaciones renales. Caso clínico. Escolar masculino de 11 años, del medio rural del estado de Jalisco, que fue picado por más de 1 000 abejas de tipo no especificado. Después de 24 horas presentó disminución en su uresis y retención de azoados, iniciando manejo con diálisis peritoneal aguda por 4 días, mientras que los indicadores de función renal se normalizaron a los 15 días de tratamiento. Conclusiones. En el paciente pediátrico que sufrió picadura masiva de abejas, se deberá mantener vigilancia estrecha de su función renal en las primeras 24 horas y en caso de presentar insuficiencia renal se deberá evaluar el manejo con diálisis peritoneal aguda.
Assuntos
Humanos , Masculino , Criança , Injúria Renal Aguda/etiologia , Abelhas/patogenicidade , Mordeduras e Picadas de Insetos/fisiopatologia , Venenos de Abelha/efeitos adversos , Necrose Tubular Aguda/etiologiaRESUMO
It is report five cases of stings of africanized bees (AB). Four of them were victims of multiple stings, varying from 25 to 60, that presented severe headache, nauseas and vomits, related to the clinic effect of the toxicity of the venom, with good evolution. The other case was victim of a single sting of AB and died after probable anaphylaxis.
Assuntos
Venenos de Abelha/efeitos adversos , Mordeduras e Picadas de Insetos , Adulto , Animais , Abelhas , Feminino , Cefaleia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/etiologia , Vômito/etiologiaRESUMO
Os autores apresentam dois casos de trauma ocular em razäo de ferroada de marimbondo, inseto da ordem dos himenópteros, mais frequentemente encontrado nas áreas rurais. As lesöes säo consequentes à açäo de componentes químicos tóxicos presentes no veneno dos insetos, que agem basicamente como alérgenos. Discute-se a fisiopatologia dos componentes do veneno inoculado, que ocasionam lesöes de intensidade variável
Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Venenos de Abelha/efeitos adversos , Traumatismos Oculares/etiologia , Himenópteros , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/cirurgiaRESUMO
Las abejas africanizadas ("abejas asesinas") se han caracterizado por su agresividad, que da origen a ataques masivos durante los cuales inyectan a su victima una cantidad importante de veneno. El veneno inyectado contiene sustancias tóxicas capaces de producir, entre otros síndromes clínicos, muerte por insuficiencia renal aguda. En este trabajo se hace revisión de la literatura, asi como un análisis de la presentación clínica y el manejo