A case of anaphylactoid shock caused by hornet stings

Sequential measurements of plasma histamine and serotonin

Abstract

A 62-year-old man, stung on 18 places by hornets, was admitted to our ICU because of consciousness disturbance. He was in severe shock and treated with epinephrine and resuscitative fluids. He was discharged on the 4th hospital day. The course of shock was considered not as anaphylaxis but as anaphylactoid reaction because his low plasma IgE levels. Seguential measurements of plasma histamine, serotonin and 5-hydroxyindole acetic acid (5-HIAA, a metabolite of serotonin) demonstrated increased concentrations of serotonin, on arrival, 6 hours after, 12 hours after, and of 5-HIAA 6 hours after admission. And therefore we concluded histamine and serotonin were likely to cause his shock.