Bee envenomation: a rare cause of thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenic purpura (TTP) is characterized by the pentad of microangiopathic hemolytic anemia, thrombocytopenia, neurologic symptoms, renal insufficiency, and fever. Although many underlying diseases and conditions are associated with TTP, there has been only one previously documented case of bee-sting-associated TTP. In this article, we describe the case of a woman who developed life-threatening TTP temporally related to a honeybee sting and who required prolonged plasma exchange before her condition improved. We also briefly review evolving concepts in the pathogenesis of TTP and speculate on the etiopathogenicity of TTP and bee envenomation.