Nittner-Marszalska Marita, Guranski Konstanty, Bladowska Joanna, Kopeć Agnieszka, Ejma Maria
Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Poland.
Department of Neurology, Wroclaw Medical University, Poland.
Cent Eur J Immunol. 2022;47(3):288-291. doi: 10.5114/ceji.2022.119153. Epub 2022 Sep 6.
Neurological complications after a single Hymenoptera insect sting are very rare. The authors of this paper describe two instances of cerebral ischemic stroke that occurred immediately after a wasp sting. Two distinct pathomechanisms involved in the cases are put forward. When diagnosing such cases, it is vital to rule out the possibility of an immunoglobulin E (IgE)-dependent reaction of hypersensitivity. However, if sIgE antibodies against wasp venom extract and/or its allergenic components are detected, after hospitalization the patient should be qualified for venom immunotherapy, which is the only efficient method of protection from severe allergic reactions caused by an insect sting. Although the incidence of ischemic stroke in patients stung by insects is very low, it is important to be aware of this complication. This will allow rapid implementation of appropriate diagnostics and treatment. The optimal stroke treatment (thrombolysis or mechanical thrombectomy) in these rare cases has not yet been established.
单次膜翅目昆虫蜇伤后的神经系统并发症非常罕见。本文作者描述了两例黄蜂蜇伤后立即发生的脑缺血性中风病例。提出了这两例病例所涉及的两种不同发病机制。诊断此类病例时，排除免疫球蛋白E（IgE）依赖性过敏反应的可能性至关重要。然而，如果检测到针对黄蜂毒液提取物和/或其致敏成分的特异性IgE抗体，患者住院后应接受毒液免疫疗法，这是预防昆虫蜇伤引起严重过敏反应的唯一有效方法。虽然昆虫蜇伤患者发生缺血性中风的发生率很低，但了解这种并发症很重要。这将有助于迅速实施适当的诊断和治疗。这些罕见病例的最佳中风治疗方法（溶栓或机械取栓）尚未确定。
