Hymenoptera
stings may be responsible for both local and systemic reactions; these can be immediate or delayed, depending on the time between the
sting and the development of signs or symptoms. Delayed clinical reactions have been reported, although unusual, due to
serum sickness and/or affecting organs or systems generally not involved in the immediate reaction, such as heart, kidneys, central and peripheral nervous systems. This paper describes the clinical and immunological findings in a 51-year-old subject, who, after two
stings of paper wasps, the second one after the third venom immunotherapy (VIT) injection, presented immediate large local and systemic
allergic reactions which quickly improved after e.v.
methylprednisolone administration. About 40 hours later, he developed acute
polyradiculoneuropathy with
muscle weakness,
paresthesia, difficulties in standing up and walking. Skin tests and specific
IgE determination showed
allergy to paper wasp. The activation, by
wasp venom, of peripheral blood mononuclear cells in primary culture, evaluated by tritiated
thymidine incorporation proliferation assay, showed an important
hypersensitivity to
wasp venom. Therefore our results suggest the hypothesis that the
polyradiculoneuritis causative etiopathogenetic mechanism might be a delayed immunological response to wasp
antigens followed by an
allergy-triggered autoimmune reaction, as previously suggested by other authors; they found lymphocytic infiltrates in demyelinization areas and at perivascular levels, by histologic examination of autoptical and bioptical material of patients with nervous system lesions after hymenoptera
stings.