Case Report
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World J Hepatology. Oct 27, 2011; 3(10): 268-270
Published online Oct 27, 2011. doi: 10.4254/wjh.v3.i10.268
Bee sting therapy-induced hepatotoxicity: A case report
Adel Nazmi Alqutub, Ibrahim Masoodi, Khalid Alsayari, Ahmed Alomair
Adel Nazmi Alqutub, Ibrahim Masoodi, Khalid Alsayari, Ahmed Alomair, Division of Gastroenterology and Hepatology, King Fahad Medical City, Riyadh 11525, Saudi Arabia
Author contributions: Alqutub AN helped with the preparation of the manuscript and the patient presented to him with progressive jaundice; Masoodi I designed the report, wrote the discussion portion and edited the whole paper; Alsayari K helped in the preparation of the clinical history portion of the report; Alomair A helped with the introductory portion of the paper and revised the manuscript.
Correspondence to: Ibrahim Masoodi, MD, DM (Gastroenterology) FACP, Division of Gastroenterology, King Fahad Medical City, Riyadh 11525, Saudi Arabia.
Telephone: +966-1-12889999-1244 Fax: +966-1-12889999-1245
Received: December 31, 2010
Revised: July 18, 2011
Accepted: October 12, 2011
Published online: October 27, 2011

The use of bee venom as a therapeutic agent for the relief of joint pains dates back to Hippocrates, and references to the treatment can be found in ancient Egyptian and Greek medical writings as well. Also known as apitherapy, the technique is widely used in Eastern Europe, Asia, and South America. The beneficial effects of bee stings can be attributed to mellitinin, an anti-inflammatory agent, known to be hundred times stronger than cortisone. Unfortunately, certain substances in the bee venom trigger allergic reactions which can be life threatening in a sensitized individual. Multiple stings are known to cause hemolysis, kidney injury, hepatotoxicity and myocardial infarction. The toxicity can be immediate or can manifest itself only weeks after the exposure. We describe hepatotoxicity in a 35-year-old female, following bee sting therapy for multiple sclerosis. She presented to our clinic 3 wk after therapy with a history of progressive jaundice. The patient subsequently improved, and has been attending our clinic now for the last 9 mo.

Keywords: Bee sting therapy, Hepatotoxicity, Mellitinin, Prothombotic state