Brumlik J
JAMA. 1976 May 10;235(19):2120-1.
A clinical picture indistinguishable fro, but not therefore identical with, myasthenia gravis (ocular form) developed within 24 hours of a wasp sting. Because of the close temporal association of events, operative mechanisms may be either an immediate hypersensitivity reaction to some components of wasp venom or a direct toxic effect of these substances on acetylcholine synthesis, release, or degradation. Theoretical considerations from the literature and the lack of immunologic abnormalities in the patient suggest that the latter may be correct. Unique host conditions must have been present at the time of the sting, implying latent or subclinical myasthenia gravis.
在黄蜂蜇伤后24小时内出现了一种与重症肌无力（眼肌型）难以区分但又不完全相同的临床表现。由于事件在时间上的紧密关联，其发病机制可能是对黄蜂毒液某些成分的即刻超敏反应，或者是这些物质对乙酰胆碱合成、释放或降解的直接毒性作用。文献中的理论思考以及患者缺乏免疫异常表明后者可能是正确的。蜇伤时患者肯定存在独特的宿主条件，这意味着存在潜在或亚临床型重症肌无力。
