Background and Aims : We report the results of clinical study into patients with bee sting, and two cases administrated rapid venom immunotherapy. Materials and Methods : A total of 245 patients with insect sting received medical treatment at Tone Central Hospital, Japan, between April 2001 and March 2003. Results : Forty eight patients experienced allergic symptoms of varying severity. Ten patients displayed grade IV anaphylaxy, no obvious correlations were identified between symptom severity and specific IgE-RAST values in response to insect venom. Rapid venom immunotherapy using long-legged wasp hymenoptera venom extract was administrated to 2 patients who displayed symptoms of shock. Maintenance dose (100μg/ml) was reached for 7 days without any adverse reactions. One of the 2 patients subsequently suffered bee sting again, but developed no symptoms of shock. Conclusion : venom immunotherapy is worth trying for patients displaying symptoms of shock following insect envenomation.
A 54-year-old type 2 diabetic woman had suffered from clouded vision indicating uveitis. Funduscopic examination showed retinal vein dilatation without diabetic retinopathy. Although urinalysis showed - to ± protein, the serum creatinine elevated. Urinary albumin excretion rate ; 29mg/g·creatinine and urine β2-microglobulin ; 9600μg/l reflected increased tubular protein excretion. Renal biopsy showed non-caseous granuloma with lymphocytic infiltration in the renal interstitium. It did not show diabetic nephropathy. The chest computed tomograms showed slightly peripheral granular shadow in bilateral lower lung fields. Pulmonary uptake of gallium-67 was positive. We diagnosed sarcoidosis accompanied by diabetes mellitus. The renal dysfunction may be caused by sarcoid granulomatous interstitial nephritis. We began giving her 40mg of methylprednisolone daily for renal involvement due to sarcoidosis. After blood glucose elevation, we then changed from glibenclamide to insulin therapy. The clouded vision subsequently recovered. Serum creatinine and urine β2-microglobulin returned to normal range.