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ARTICLE |

Myasthenia Gravis Associated With Wasp Sting FREE

Joel Brumlik, MD
[+] Author Affiliations

Reprint requests to Department of Neurology, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153 (Dr Brumlik).


JAMA. 1976;235(19):2120-2121. doi:10.1001/jama.1976.03260450032026
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A clinical picture indistinguishable from, 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.

(JAMA 235:2120-2121, 1976)

REFERENCES

Barnard JH:  Studies of 400 Hymenoptera sting deaths in the United States . J Allergy Clin Immunol 52:259-264, 1973;.
Barnard JH:  Nonfatal results in third-degree anaphylaxis from Hymenoptera stings . J Allergy 45:92-96, 1970;.
Barr SE:  Allergy to Hymenoptera stings: Review of the world literature/p1953-1970 . Ann Allergy 29:49-66, 1971;.
Goldstein NP, Rucker W, Woltman HW:  Neuritis occurring after insect stings . JAMA 173:1727-1730, 1960;.
Ross AT:  Peripheral neuritis: Allergy to honeybee stings . J Allergy Clin Immunol 10:382-384, 1939;.
Wallace TW, Ludwig RN:  Hornet sting neuritis . Cleve Clin Q 37:117-118, 1970;.
Jellinger K, Spunda C:  Aufsteigende Neuritis nach Insektenstich . Wien Klin Wochenschr 73:726, 1953;.
Means ED, Barron KD, Van Dyne BJ:  Nervous system lesions after sting by yellow jacket . Neurology 23:881-890, 1973;.
Habermann E:  Bee and wasp venoms: The pharmacology of their peptides and enzymes are reviewed . Science 177:314-322, 1972;.
Sobotka AK, Valentine MD, Benton AW, et al:  Allergy to insect stings: I. Diagnosis of IgE-mediated Hymenoptera sensitivity by venom-induced histamine release . J Allergy Clin Immunol 53:170-184, 1974;.
Lichtenstein LM, Valentine MD, Sobotka AK:  A case for venom treatment in anaphylactic sensitivity to Hymenoptera sting . N Engl J Med 290:1223-1227, 1974;.
Kornguth SE, Hanson JC, Chun RWM:  Antineuronal antibodies in patients having myasthenia gravis . Neurology 20:749-755, 1970;.
Brumlik J, Jacobs RS:  Myasthenia gravis associated with diphenylhydantoin therapy for epilepsy . Can J Neurol Sci 1:127-129, 1974;.
McQuillen MP, Cantor HE, O'Rourke JR:  Myasthenic syndrome associated with antibiotics . Arch Neurol 18:402-413, 1968;.

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Barnard JH:  Studies of 400 Hymenoptera sting deaths in the United States . J Allergy Clin Immunol 52:259-264, 1973;.
Barnard JH:  Nonfatal results in third-degree anaphylaxis from Hymenoptera stings . J Allergy 45:92-96, 1970;.
Barr SE:  Allergy to Hymenoptera stings: Review of the world literature/p1953-1970 . Ann Allergy 29:49-66, 1971;.
Goldstein NP, Rucker W, Woltman HW:  Neuritis occurring after insect stings . JAMA 173:1727-1730, 1960;.
Ross AT:  Peripheral neuritis: Allergy to honeybee stings . J Allergy Clin Immunol 10:382-384, 1939;.
Wallace TW, Ludwig RN:  Hornet sting neuritis . Cleve Clin Q 37:117-118, 1970;.
Jellinger K, Spunda C:  Aufsteigende Neuritis nach Insektenstich . Wien Klin Wochenschr 73:726, 1953;.
Means ED, Barron KD, Van Dyne BJ:  Nervous system lesions after sting by yellow jacket . Neurology 23:881-890, 1973;.
Habermann E:  Bee and wasp venoms: The pharmacology of their peptides and enzymes are reviewed . Science 177:314-322, 1972;.
Sobotka AK, Valentine MD, Benton AW, et al:  Allergy to insect stings: I. Diagnosis of IgE-mediated Hymenoptera sensitivity by venom-induced histamine release . J Allergy Clin Immunol 53:170-184, 1974;.
Lichtenstein LM, Valentine MD, Sobotka AK:  A case for venom treatment in anaphylactic sensitivity to Hymenoptera sting . N Engl J Med 290:1223-1227, 1974;.
Kornguth SE, Hanson JC, Chun RWM:  Antineuronal antibodies in patients having myasthenia gravis . Neurology 20:749-755, 1970;.
Brumlik J, Jacobs RS:  Myasthenia gravis associated with diphenylhydantoin therapy for epilepsy . Can J Neurol Sci 1:127-129, 1974;.
McQuillen MP, Cantor HE, O'Rourke JR:  Myasthenic syndrome associated with antibiotics . Arch Neurol 18:402-413, 1968;.
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