Bee Sting Allergy and Polymyalgia
Periodically, people have asked about bee sting allergy and polymyalgia. Is there a relationship between the two?
David E. Bilstrom, MD
Stinging insects such as bees, wasps, hornets, and fire ants can cause 3 types of adverse reactions. The first type is an allergic reaction, and this occurs in patients who have been sensitized by a previous insect sting. In this case, being "sensitized" means that the patient has developed a specific kind of antibody -- called immunoglobulin (Ig) E -- that is specific for the insect venom. The IgE binds to the surface of white blood cells known as "mast" cells, and when a sensitized individual is stung, allergic reactions can occur. These typically happen soon after a sting, and commonly cause itching, swelling, and flushing of the skin. With more severe reactions, breathing or circulatory problems can develop, and these require immediate medical therapy.
In addition to the typical allergic reaction, insect stings can also cause large local reactions and toxic reactions. Large local reactions consist of swelling, which in some cases is quite dramatic, in the area around where the sting occurred. Although uncomfortable, they are generally not dangerous. Toxic reactions can occur in cases involving multiple stings, and are a result of exposure to large amounts of venom. These reactions are sometimes serious, especially in the very young or in individuals with other health problems.
There is no proven connection between insect stings and polymyalgia, which is also known as polymyalgia rheumatica. This disorder, which generally affects older individuals, is characterized by aching and stiffness of the shoulders and hips; and the pain can be quite severe. A serious condition that is often found together with polymyalgia is giant-cell arteritis, an inflammatory condition involving the large arteries. Plugging of the arteries can cause a number of different complications depending on the location of the blood vessel.
Polymyalgia and giant-cell arteritis are considered to be closely related autoimmune diseases that can coexist. When arteritis is present, there is evidence that the body's own immune system damages large blood vessels. It is likely that certain individuals may be at greater risk of developing these disorders due to specific genes involved in immune recognition. It is possible that certain types of infections then trigger the immune system to injure the blood vessels, but the exact mechanisms are speculative. If this disorder is suspected, it is important to promptly seek medical care because effective treatments are available, and because complications of untreated polymyalgia/giant-cell arteritis are potentially serious.
Periodically, people have asked about bee sting allergy and polymyalgia. Is there a relationship between the two?
David E. Bilstrom, MD
Stinging insects such as bees, wasps, hornets, and fire ants can cause 3 types of adverse reactions. The first type is an allergic reaction, and this occurs in patients who have been sensitized by a previous insect sting. In this case, being "sensitized" means that the patient has developed a specific kind of antibody -- called immunoglobulin (Ig) E -- that is specific for the insect venom. The IgE binds to the surface of white blood cells known as "mast" cells, and when a sensitized individual is stung, allergic reactions can occur. These typically happen soon after a sting, and commonly cause itching, swelling, and flushing of the skin. With more severe reactions, breathing or circulatory problems can develop, and these require immediate medical therapy.
In addition to the typical allergic reaction, insect stings can also cause large local reactions and toxic reactions. Large local reactions consist of swelling, which in some cases is quite dramatic, in the area around where the sting occurred. Although uncomfortable, they are generally not dangerous. Toxic reactions can occur in cases involving multiple stings, and are a result of exposure to large amounts of venom. These reactions are sometimes serious, especially in the very young or in individuals with other health problems.
There is no proven connection between insect stings and polymyalgia, which is also known as polymyalgia rheumatica. This disorder, which generally affects older individuals, is characterized by aching and stiffness of the shoulders and hips; and the pain can be quite severe. A serious condition that is often found together with polymyalgia is giant-cell arteritis, an inflammatory condition involving the large arteries. Plugging of the arteries can cause a number of different complications depending on the location of the blood vessel.
Polymyalgia and giant-cell arteritis are considered to be closely related autoimmune diseases that can coexist. When arteritis is present, there is evidence that the body's own immune system damages large blood vessels. It is likely that certain individuals may be at greater risk of developing these disorders due to specific genes involved in immune recognition. It is possible that certain types of infections then trigger the immune system to injure the blood vessels, but the exact mechanisms are speculative. If this disorder is suspected, it is important to promptly seek medical care because effective treatments are available, and because complications of untreated polymyalgia/giant-cell arteritis are potentially serious.
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