THROMBOTIC thrombocytopenic purpura (TTP) is a complex, poorly understood syndrome diagnosed in patients with evidence of microangiopathic hemolytic anemia, thrombocytopenia, renal failure, neurological disease, and fever. The prognosis is poor. Occasionally patients survive after a variety of therapeutic maneuvers. We describe a patient who had the clinical pentad of the TTP syndrome following anaphylaxis secondary to a bee sting. She recovered completely without therapy.
Report of a Case
A 44-year-old woman was admitted to the hospital with complaints of anorexia, fatigue, jaundice, and severe retro-orbital headache. Seventy-two hours before admission, she was stung on the lower lip by a honeybee. She had previously been given Hymenopteran-whole-body-extract desensitization injections, but had stopped receiving them two years earlier. Because of three previous anaphylactic reactions from Hymenoptera stings, the patient had been taught to administer epinephrine hydrochloride subcutaneously to herself.Minutes after the sting in the present case, the patient lost consciousness and