Allergy Asthma Immunol Res.  2015 Sep;7(5):513-517. 10.4168/aair.2015.7.5.513.

Bee Pollen-Induced Anaphylaxis: A Case Report and Literature Review

• Choi JH
• Jang YS
• Oh JW
• Kim CH
• Hyun IG

• KMID: 2147961
• DOI: http://doi.org/10.4168/aair.2015.7.5.513

Abstract

Bee pollen is pollen granules packed by honey bees and is widely consumed as natural healthy supplements. Bee pollen-induced anaphylaxis has rarely been reported, and its allergenic components have never been studied. A 40-year-old male came to the emergency room with generalized urticaria, facial edema, dyspnea, nausea, vomiting, abdominal pain, and diarrhea 1 hour after ingesting one tablespoon of bee pollen. Oxygen saturation was 91%. His symptoms resolved after injection of epinephrine, chlorpheniramine, and dexamethasone. He had seasonal allergic rhinitis in autumn. Microscopic examination of the bee pollen revealed Japanese hop, chrysanthemum, ragweed, and dandelion pollens. Skin-prick with bee pollen extracts showed positive reactions at 0.1 mg/mL (A/H ratio > 3+). Serum specific IgE to ragweed was 25.2, chrysanthemum 20.6, and dandelion 11.4 kU/L; however, Japanese hop, honey-bee venom and yellow-jacket venom were negative (UniCAP(R), Thermo Fisher Scientific, Uppsala, Sweden). Enzyme-linked immunosorbent assay (ELISA) confirmed serum specific IgE to bee-pollen extracts, and an ELISA inhibition assay for evaluation of cross-allergenicity of bee pollen and other weed pollens showed more than 90% of inhibition with chrysanthemum and dandelion and ~40% inhibition with ragweed at a concentration of 1 microg/mL. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and IgE-immunoblot analysis revealed 9 protein bands (11, 14, 17, 28, 34, 45, 52, 72, and 90 kDa) and strong IgE binding at 28-34 kDa, 45 and 52 kDa. In conclusion, healthcare providers should be aware of the potential risk of severe allergic reactions upon ingestion of bee pollen, especially in patients with pollen allergy.

Keyword

Pollen; bees; anaphylaxis; immunoglobulin E

MeSH Terms

Abdominal Pain
Adult
Ambrosia
Anaphylaxis*
Asian Continental Ancestry Group
Bees*
Chlorpheniramine
Chrysanthemum
Dexamethasone
Diarrhea
Dyspnea
Eating
Edema
Electrophoresis, Polyacrylamide Gel
Emergency Service, Hospital
Enzyme-Linked Immunosorbent Assay
Epinephrine
Health Personnel
Honey
Humans
Humulus
Hypersensitivity
Immunoglobulin E
Male
Nausea
Oxygen
Pollen
Rhinitis, Allergic, Seasonal
Sodium Dodecyl Sulfate
Taraxacum
Urticaria
Venoms
Vomiting
Chlorpheniramine
Dexamethasone
Epinephrine
Immunoglobulin E
Oxygen
Sodium Dodecyl Sulfate
Venoms

Figure

• 

  Fig. 1 Microscopic contents of bee pollen. The microscopic findings show several pollens, including Japanese hop, chrysanthemum, ragweed, and dandelion.

• 

  Fig. 2 Bee pollen ELISA inhibition results using bee pollen, chrysanthemum, dandelion, ragweed, and Japanese hop antigens. Chrysanthemum and dandelion show >90% inhibition at 1 µg/mL. Ragweed shows ~40% inhibition at 1 µg/mL, and Japanese hop shows relatively weak inhibition. Dp, Dermatophagoides pteronyssinus.

• 

  Fig. 3 Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) (A) and IgE-immunoblot analysis (B) of bee-pollen extracts in sera of the patient and normal controls (NC). IgE-immunoblot results show prominent bands at 28-34, 45, and 50 kDa. M, standard marker; B, buffer control.

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