Foreign-body granuloma and IgE-pseudolymphoma after multiple bee stings.
We report a patient with an unusual combination of an eosinophilic foreign-body granuloma and a pseudolymphoma, with recurrent severe oedema on the forehead, after multiple bee stings. On immunohistology the foreign-body granuloma and lymphoid follicles reacted with monoclonal antibodies against the high- and low-affinity IgE receptors, and against IgE. Prick and intradermal tests with whole-body bee extracts showed positive immediate-type reactions. The eosinophilic granuloma formation and lymphoid follicles may have been induced by a combination of immune complex and cell-mediated hypersensitivity following antigen persistence. Although bee stings are common, as far as we are aware, this complex reaction pattern has not been reported previously.
Hermes
B
B
Department of Dermatology, University Clinics Rudolf Virchow, Free University, Berlin, Germany.
Haas
N
N
Grabbe
J
J
Czarnetzki
B M
BM
D000818:Animals; D001516:Bees; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007150:Immunohistochemistry; D007299:Insect Bites and Stings / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017455:Receptors, IgE / Q000276:immunology; D012867:Skin / Q000473:pathology
D017455:Receptors, IgE; D007073:Immunoglobulin E