title: Immune thrombocytopenia after bee venom therapy: a case report.
abstract: BACKGROUND
  Immune thrombocytopenia (ITP) is a hematological disorder with an isolated decrease in number of circulating platelets. Bee venom therapy (BVT) is a form of alternative medicine. It is still being practiced in the Middle East and other parts of Asia. In BVT, acupuncture points are used to inject diluted bee venom into the body. The pharmacological basis behind BVT is not fully understood. However, it has been used to treat various medical conditions such as arthritis and low back pain. On the other hand there have been a number of reported complications of BVT use such as ITP. We present a case report on ITP after BVT.
  
  
  METHODS
  A 61 year old lady presented with gum bleeding and ecchymosis and found to have isolated thrombocytopenia (platelet count of 9 × 10(9)/L) after receiving four direct bee sting sessions. There was no evidence of any other risk factors of ITP.
  
  
  CONCLUSIONS
  Bee venom components and toxicity may be associated with thrombocytopenia as a complication. Further research is needed to postulate guidelines and protocol for BVT. In the meantime, monitoring of the practice of BVT should be made, with an emphasis on patient education regarding the safety profile and associated risks compared to the gained benefits.
authors.affiliation: Department of Internal Medicine, Mubarak Al-Kabeer Hospital, P.O. Box 800, Dasman, 15458, Kuwait.
authors.forename: Mohammad Adel
authors.initials: MA
authors.lastname: Abdulsalam
authors.affiliation: Department of Internal Medicine, Mubarak Al-Kabeer Hospital, P.O. Box 800, Dasman, 15458, Kuwait.
authors.forename: Bader Esmael
authors.initials: BE
authors.lastname: Ebrahim
authors.affiliation: Department of Internal Medicine, Mubarak Al-Kabeer Hospital, P.O. Box 800, Dasman, 15458, Kuwait. a7medo@gmail.com.
authors.forename: Ahmad Jasem
authors.initials: AJ
authors.lastname: Abdulsalam
mesh_terms: D001514:Bee Venoms / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced*
chemical_list: D001514:Bee Venoms
keywords: Acupuncture; Bee; Complication; Hematology; Immune; PLA2; Therapy; Thrombocytopenia; Venom