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[Allergic encephalomyelopolyradiculoneuritis from a wasp sting (clinico-pathologic report)].

The authors discuss clinico-pathomorphological observations of allergic encephalomyelopolyradiculoneuritis, due to wasp stings. A lethal outcome followed the 14th day of the disease. The clinical picture and morphological symptoms were characterized by allergic reactions of immediate and retarded types leading to severe lesions of the vital organs and the nervous system. Special attention is drawn to a selective lesion of the pallidonigral system conditioning the clinical picture of acutely developing parkinsonism. The polyradiculoneuritis and myelitical syndrome were also expressed.

Blood Vessels↗

Bee sting of the cornea.

Irreversible heterochromia-iridis, internal ophthalmoplegia, and punctate subcapsular lenticular opacities developed in a 9-year-old girl after she received a bee sting in her right cornea. These complications persisted even after an 11-month follow-up period. To the author's knowledge, this presentation is the first of its nature. The pathogenesis of these changes is discussed and the literature is reviewed.

Bees↗

[Causal treatment of stinging insect allergy].

Allergic reactions following stings by bees and vespids are not frequent but often dramatic. Immunotherapy may be of vital importance and was made up to now by wholebody extracts. Meanwhile we know the superiority of pure venoms. Considering the risks and costs of venom immunotherapy indication must be very strict however. Treatment should be started in specialized centres. 50 patients where treated with Reless -insect venoms. From this experience results the "Darmstädter Schema" of rush hyposensitization. By this schedule accumulate effects become less, maximum dose will be reached in 5 days, patients are not so stressed and treatment costs go down.

Adolescent↗

Bee sting of the cornea: case report.

Three cases of corneal bee sting were treated. Each eye reacted differently from the others: case 1 with severe pain, conjunctival chemosis and hyperemia, central corneal edema, and reduced visual acuity; case 2 with severe pain, conjunctival hyperemia, and a white corneal infiltrate; and case 3 with only a minimal foreign-body sensation. The reaction to the venom can be toxic or immunologic. The behavior of the toxins-melittin, apamin, and formic acid-and of the principal allergen (probably phospholipase A) are described.

Adult↗

[Stings by venomous cones observed in New Caledonia and dependencies (author's transl)].

Authors review height cases of stings by venomous cones observed in New Caledonia. They describe the morphology of the venom apparatus of these attracting molluscs and emphasize the severity of the injuries. Prognosis is the worst in children, and Conus geographus is the most dangerous species of the genus Conus. There is no valuable treatment and prevention is the sole protection.

Animals↗

Near-fatal and fatal anaphylactic reactions to insect sting.

Two patients experienced anaphylactic reaction to insect stings, with residual encephalopathy. One patient had anaphylaxis despite hyposensitization with whole-body extracts, thus supporting recent reports that reliable protection cannot be achieved unless pure venom is used. The other patient had pathologic confirmation of anoxic encephalopathy, thus supporting the concept that encephalopathy with anaphylaxis is secondary to associated circulatory collapse rather than a primary allergic response of brain disease.

Allergens↗

[Obsessional-type compulsive behavior caused by bilateral circumscribed pallidostriatal necrosis. Encephalopathy caused by a wasp sting].

A previously healthy young man developed encephalopathy after a wasp sting in 1968. Neurological complications included chorea, currently of a minor degree, replaced by buccofacial dyskinesias and compulsive movements. The most disabling consequences were of psychic nature, the patient presenting an unusually marked compulsive activity of an obsessional type. The whole psychic picture however was quite different from that of the usual neurosis, since there was neither anxiety nor doubt, but a mental vacuum contrasting with almost normal intellectual and affective capacities. It was as though there was a loss of the auto-activation system of psychic life, postulated by dynamic psychologists. C.A.T. demonstrated bilateral pallidostriatal necrosis. This suggests that the striatum plays a motor and psychic role. In the field of motor control, its hypoactivity appears to determine not only chorea but dyskinesias similar to tics and compulsive movements. In the psychic field, the striatum appears to play the very general role of an auto-activation system of intellectual and affective life, its deficiency leading to mental activity of a compulsive nature. Improvement in knowledge of striatal biology should clarify not only the basic mechanisms of chorea, but those of tics and obsessions.

Brain Diseases↗

[Antibody response pattern (specific IgE and IgG) of insect sting allergic patients in immunotherapy with venom preparations].

The concentrations of venom specific IgE (Phadebas-RAST) and IgG (Phadebas IgG-RAST) were monitored in sera of 22 patients with histories of systemic anaphylactic reactions following insect stings who underwent immunotherapy with venom extracts (bee venom and/or yellow jacket venom). Analysis of the immunological parameters during immunotherapy revealed great individual variation in the degree of response concerning both specific IgE and IgG antibodies. Nevertheless, four typical patterns of immune response could be found. The majority of the patients were able to produce high titers of IgG "blocking" antibodies without an IgE increase. Another group of patients had a marked rise in both specific IgG and IgE following the initial phase of hyposensitization. In contrast, one patient received venom injections without a significant IgG or IgE response. Finally, a small group of patients has a marked increase in specific IgE while synthesis of IgG was not observed. This IgE rise was the cause of systemic reactions in this group after the venom injections. Regular monitoring of venom specific IgE and IgG is useful in evaluating the degree of protection for the patient. Since an increasing IgG/IgE ratio must be obtained during immunotherapy, a knowledge of this relationship serves to adapt the individual treatment schedule.

Adolescent↗

Stingose. A new and effective treatment for bites and stings.

Stingose, an aqueous solution of 20% aluminum sulphate and 1.1% surfactant, has been developed as a wide-acting and effective first-aid treatment designed to counteract the venoms of insects, bees, marine stingers and stinging plants. Rapid application to prevent further systemic abosorption is necessary. As virtually all characterized insect, marine, and spiked-fish venoms contain a protein component, it is proposed that the Al3+ ion in Stingose interacts with proteins and long-chain polysaccharide components to denature and inactivate the venoms. It is also proposed that an osmotic fluid movement towards the high ionic strength solution could account for part of the action of the product. In an extensive field trial which involved 1003 cases, the over-all success of first-aid treatment with Stingose in 997 cases and partial success in six cases was extremely high. Further work is to be undertaken to study the range of envenomations against which Stingose is active.

Adult↗

[Anaphylaxis due to a sting by Argas reflexus (the pigeon tick) A case report].

A case of anaphylactic shock caused by an Argas reflexus sting in a young woman with a history of recurrent undefined urticaria-angioedema syndrome, is reported. This tick is an ectoparasite which is found on pigeons who usually nest under the roofs of dwellings. The diagnosis was based on the history and through a dosage of IgE specific antibodies with RAST, using an extract of salivary gland of Argas reflexus. This ectoparasite was also found in the home and identified through the microscope. It is known to be the potential carrier of the Borrelia burgdorferi, which is the vector of Lyme disease. In our case Argas reflexus caused IgE-mediated reactions and therefore this hypothesis must be considered in the investigation of urticaria-angioedema syndrome or anaphylactic shock in patients who live in houses with pigeons' nests.

Adolescent↗

Remedies for common family ailments: 4. Insect bites and stings.

For going abroad, taking the correct anti-malarial medication should have high priority. Insect-repellents are a useful preventative. Products to treat insect bites and stings include astringents local anaesthetics antihistamines corticosteroids and crotamiton.

Humans↗

Epileptic attacks associated with wasp sting-induced anaphylaxis.

We report the case of a patient who suffered two epileptic attacks, each one associated with an anaphylactic shock due to wasp venom. He had no history of atopy nor any known diseases. Previous wasp stings had been well tolerated. An IgE-mediated hypersensitivity to the venom was shown both by cutaneous and immunologic tests. Specific IgE against Polistes spp. venom was 0.86 kU/I (RAST method), and intradermal tests with Polistes spp. venom were positive at a concentration of 1 microgram/ml. Cutaneous tests and serum specific IgE against Vespula spp. and Apis mellifera venoms were negative. In addition to that, wasp venom immunotherapy has been a highly effective treatment. Although convulsions may occur as a complication of anaphylaxis, only a few cases have been reported in the literature because of wasp venom. In our patient, it seems more likely that the epileptic attacks were due to anoxemia due to hypotension caused by vasodilatation and cardiac involvement in anaphylaxis.

Anaphylaxis↗

[Change in venom-specific IgE levels during 2-year follow-up in five cases with a history of Hymenoptera sting].

Levels of specific IgE antibodies to three kinds of venom (honeybee, wasp and yellow jacket) were followed up for two years in five male pest control operators (age: 24 to 50 years) with Hymenoptera sting within the latest six months. At the first examination, all subjects had a positive reaction for venom-specific IgE but their levels were varied in the range from class 2 to 5 (0.70 approximately 99.9 UA/ml), and a positive reaction was observed in the case of unoffending Hymenoptera. A subject who was re-stung during the two-year follow-up period showed increase in all of the venom-specific IgE levels. Of four subjects without re-stung during the two years, three subjects had a logarithmic decrease in all the specific IgE levels time-dependently, but one subject with a high total serum IgE level showed an increase and decrease alternately in the specific IgE The total serum IgE level may be a factor which influences the change in the venom-specific IgE level. In the four subjects without a high total serum IgE level, the biological half-life of venom-specific IgE was estimated to be 6 to 12 months based on the decreased level during the follow-up period.

Adult↗

[Massive poisoning by African bee stings].

BACKGROUND: Bee stings can cause severe toxic effects when envenomation is massive. CASE REPORT: While touring in Casamance (Southern Senegal) a white male was severely stung by a swarm of African bees. The massive envenomation caused rhabdomyolysis, hemolysis and acute renal failure. Pathology examination of kidney and bladder specimens showed vasculitis affecting both arteries and veins. The patient was treated with several hemodialysis sessions and renal function returned to normal three months after the incident. DISCUSSION: Bees in Africa, known as "killer bees", are particularly aggressive. They have recently been imported from tropical zones in America where a large number of deaths have been reported. Most cases of massive envenomation have shown acute tubular necrosis or renal involvement with myoglobinuria or hemoglobinuria. The renal pathology observed in our case is not usually described.

Acute Kidney Injury↗

Purification, crystallization, and preliminary X-ray studies on the rhizome lectin from stinging nettle and its complex with NN'N"-triacetylchitotriose.

Single crystals were grown from affinity-purified stinging nettle lectin and from its complex with the specific trisaccharide NN'N"-triacetylchitotriose by vapor diffusion at room temperature. The lectin crystallizes in space group P2(1)2(1)2(1) with unit cell dimensions a = 54.3 (1) A, b = 62.2 (1) A, and c = 92.4 (2) A, and diffracts to 3.0 A resolution. The asymmetric unit contains three lectin monomers. The crystals of the lectin-trisaccharide complex have space group P2(1)2(1)2(1) with cell constants a = 37.69 (4) A, b = 48.97 (6) A, and c = 57.32 (4) A. These crystals diffract to at least 2.0 A resolution and the asymmetric unit contains one lectin monomer. A three-dimensional X-ray structure determination is on its way.

Binding Sites↗

Ameliorative effect of IDS 30, a stinging nettle leaf extract, on chronic colitis.

BACKGROUND AND AIMS: Anti-TNF-alpha antibodies are very effective in the treatment of acute Crohn's disease, but are limited by the decline of their effectiveness after repeated applications. The stinging nettle leaf extract, IDS 30, is an adjuvant remedy in rheumatic diseases dependent on a cytokine suppressive effect. We investigated the effect of IDS 30 on disease activity of murine colitis in different models. METHODS: C3H.IL-10-/- and BALB/c mice with colitis induced by dextran sodium sulphate (DSS) were treated with either IDS 30 or water. Mice were monitored for clinical signs of colitis. Inflammation was scored histologically, and faecal IL-1beta and mucosal cytokines were measured by ELISA. Mononuclear cell proliferation of spleen and Peyer's patches were quantified by 3H-thymidine. RESULTS: Mice with chronic DSS colitis or IL-10-/- mice treated with IDS 30 clinically and histologically revealed significantly (p < 0.05) fewer signs of colitis than untreated animals. Furthermore, faecal IL-1beta and mucosal TNF-alpha concentrations were significantly lower (p < 0.05) in treated mice. Mononuclear cell proliferation after stimulation with lipopolysaccharide was significantly (p < 0.001) reduced in mice treated with IDS 30. CONCLUSIONS: The long-term use of IDS 30 is effective in the prevention of chronic murine colitis. This effect seems to be due to a decrease in the Th1 response and may be a new therapeutic option for prolonging remission in inflammatory bowel disease.

Animals↗

Carbohydrate binding properties of the stinging nettle (Urtica dioica) rhizome lectin.

The interaction of the stinging nettle rhizome lectin (UDA) with carbohydrates was studied by using the techniques of quantitative precipitation, hapten inhibition, equilibrium dialysis, and uv difference spectroscopy. The Carbohydrate binding site of UDA was determined to be complementary to an N,N',N"-triacetylchitotriose unit and proposed to consist of three subsites, each of which has a slightly different binding specificity. UDA also has a hydrophobic interacting region adjacent to the carbohydrate binding site. Equilibrium dialysis and uv difference spectroscopy revealed that UDA has two carbohydrate binding sites per molecule consisting of a single polypeptide chain. These binding sites either have intrinsically different affinities for ligand molecules, or they may display negative cooperativity toward ligand binding.

Binding Sites↗