Nair Rajeev, Riddle Emily A, Thrall Mary Anna
Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
Vet Clin Pathol. 2019 Dec;48(4):620-623. doi: 10.1111/vcp.12747. Epub 2019 Jun 22.
This case report describes a massive honey bee envenomation in a 14-month-old male Belgian Malinois dog from St. Kitts, West Indies. Acute and delayed onsets of hemolytic anemia, echinocytosis, spherocytosis, thrombocytopenia, hemoglobinemia, and hemoglobinuria developed following envenomation. The dog recovered after treatment with glucocorticoids and supportive therapy. Spherocytosis, hemolysis, and thrombocytopenia in patients with massive bee envenomation are likely due to the direct toxic effects of the primary components of bee venom, melittin and phospholipase A (PLA ). Mellitin causes hemolysis by forming large pores in erythrocytes resulting in leakage of hemoglobin and also causes spectrin stiffening and resultant echinocyte and spherocyte formation. Melittin also stimulates PLA , a hydrolase that causes echinocytosis and spherocytosis, in vivo and in vitro, and mitochondrial breakdown in platelets. However, delayed manifestations could be attributed to immune-mediated mechanisms from the generation of antibodies against damaged erythrocytes and platelet membrane proteins.
本病例报告描述了一只来自西印度群岛圣基茨的14个月大雄性比利时马林诺斯犬发生的大规模蜜蜂蜇伤事件。蜇伤后出现了急性和延迟性溶血性贫血、棘红细胞增多、球形红细胞增多、血小板减少、血红蛋白血症和血红蛋白尿。该犬经糖皮质激素治疗和支持治疗后康复。大量蜜蜂蜇伤患者出现的球形红细胞增多、溶血和血小板减少可能是由于蜂毒主要成分蜂毒肽和磷脂酶A（PLA）的直接毒性作用。蜂毒肽通过在红细胞中形成大孔导致血红蛋白泄漏而引起溶血，还会导致血影蛋白变硬，从而形成棘红细胞和球形红细胞。蜂毒肽还在体内和体外刺激PLA（一种导致棘红细胞增多和球形红细胞增多的水解酶）以及血小板中的线粒体分解。然而，延迟表现可能归因于针对受损红细胞和血小板膜蛋白产生抗体的免疫介导机制。
