Armaghane Danesh Bimonthly Journal (Oct 2018)
Systemic Lupus Erythematosus Triggered by Bee Sting: A Case Report
Abstract
Abstract Background and objectives: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that affects multiple organs. The etiology of SLE is not exactly defined. However, genetic and environmental factors, hormones and infections have been identified as triggers for SLE. Several organ systems can be damaged following SLE. In the present study, a case of SLE, triggered by bee sting and presented with renal involvement is reported. Methods: This study presents a case report of SLE, triggered by bee sting. Data gathering sheet was prepared. Demographic information, clinical and lab data were observed and medical records were considered. Informed consent was obtained. Patient presentation: An 11-year-old boy was admitted to the hospital with the history of fever, malar rash and joint pain, presented from 20 days ago. The child had no presentations of the disease, until he was stung by a bee on his neck. Two weeks later, he developed generalized rash, malar rash, arthritis and photosensitivity. In lab data; anemia, proteinuria, increased levels of anti-nuclear antibody, anti-double strand DNA and erythrocyte sedimentation rate were observed. Class III of nephritis was observed based on the renal biopsy. Treatment with prednisolone and hydroxychloroquine was started and in one year of follow up, favorable outcomes were observed. Conclusions: Based on the presented case and the previous reports, it seems that bee venom might play a dual role in the immune system. Although the beneficial effects of bee venom have been observed in some autoimmune diseases (arthritis), some of the autoimmune diseases have been triggered by bee venom (such as Guillain-Barre syndrome, Henoch-Shonleine purpura, myocarditis and nephritis). This study is of the few studies, reporting SLE following bee sting. So, considering the reported adverse effects of bee venom, the application of bee venom in the treatment of diseases should be reconsidered.