Hi all
I have been researching the effects of bee stings. I found this old article which I thought might be of interest to beekeepers
Sensitivity to insect stings in patients taking anti-inflammatory drugs
Bee sting are known to cause various reactions in different patients as well as on different occasions in the same patient. Anaphylactic reactions have been described in people who had previously developed no reaction to bee stings, and apparent spontaneous cure of their sen=sitivity has been reported. We report two cases of sensitivity to bee stings occurring while patients were taking anti-inflammatory drugs.
Case reports
Case 1 — A 66 year old beekeeper had developed apparent immunity to bee stings over six years. She was prescribed diclofenac 50 mg three times daily for severe bilateral hip osteoarthrosis, not taking other drugs and never having taken steroids. Some months after starting the anti-inflammatory treatment, however, she was stung on the wrists while attending her beehives and within 15 minutes developed an alarming reaction with palpitations, a rash over the trunk and limbs, and swelling of the mouth and tongue causing dyspnoea. This settled spontaneously within a few hours. The following day she did not take any drugs but again sustained several bee sings, and although a similar reaction developed, it was much milder. The next day -- 48 hours after her last dose of the diclofenac -- further bee stings had no effect. She took no more anti-inflammatory drugs and had no further reactions.
Case 2 — The 48 year old wife of a beekeeper had previously had only local reactions to wasp stings. She had taken ibuprofen for osteoarthritis of the spine for five months before she was stung by a wasp. Within two minutes generalised swelling, red itchy rash, palpitations, and shortness of breath developed, with a sense of impending doom. Treatment in hospital for 24 hours included parenteral adrenaline, antihistamine, and hydrocortisone. Another wasp stung her two days Later, after she had stopped taking ibuprofen, and a less severe reaction developed, possibly helped by speedier transfer to-hospital. Further anti-inflammatory drugs were taken and she began a course of desensitisation to wasp venom.
Comment
Immunity to bee stings is well known among beekeepers, indeed it appears that people get temporary relief from the pain of arthritis if they sustain several bee stings. Allergy to insect stings is a local or system type I immediate hypersensitivity reaction mediated by IgE. The effect of allergy to anti-inflammatory drugs may not be the same in all subjects, as has been shown in asthmatic patients sensitive to aspirin. Treatment with anti-inflammatory drugs is widespread and may be overlooked in victims of bee stings as a possible complicating factor.
We have found no previous report saying that diclofenac, ibuprofen, or other non-steroidal anti-inflammatory drugs can reversibly modify the immune response. Though changes in specific tests have been shown in animal and in vitro experiments, no noticeable general immune-suppression has been reported in a clinical situation.
We think that all beekeepers should be warned of this possible hazard if prescribed non-steroidal anti-inflammatory drugs.
Bernard, A. A., & Kersley, J. B. (1986). Sensitivity to insect stings in patients taking anti-inflammatory drugs. British medical journal (Clinical research ed.), 292(6517), 378.
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