Abstract
IntroductionBee-venom acupuncture (BVA) has been widely applied to various disorders including pain-related diseases; however, patients are often warned of adverse reactions such as anaphylaxis. This study aimed to estimate the risk of hypersensitivity reactions to BVA and to determine their clinical features.MethodsWe retrospectively surveyed the medical records of patients treated by BVA between January 2010 and April 2019 in Dunsan Hospital of Daejeon University, and all cases of allergic reactions and their clinical symptoms were analyzed.ResultsA total of 8,580 patients (males 4,081 and females 4,499) were treated with BVA which amounts to a total of 60,654 treatments (average 7.1 ± 14.8 times). A total of fifteen patients (7 males and 8 females) reported an allergic reaction (0.175%, 95% CI, 0.086–0.263) of type 1 hypersensitivity, indicating a rate of allergic reaction in 0.025% (95% CI, 0.012–0.037) of the total BVA treatments. The average number of BVA treatments in those patients was 6.9 ± 6.5 (males: 4.1 ± 3.4 and females: 9.3 ± 7.9). Among the cases of hypersensitivity reactions, 4 involved anaphylactic shock; therefore, the incidence rate of anaphylaxis was 0.047% (95% CI, 0.001–0.092) for the 8,580 subjects and 0.007% (95% CI, 0.000–0.013) for the 60,654 treatments. All grade 1 cases were recovered within 1 day, whereas others took up to 30 days for complete recovery.ConclusionOur results may emphasize paying attention to unforeseeable risks of anaphylaxis after bee-venom acupuncture. This study could be essential reference data for the guidelines of appropriate use of bee-venom acupuncture and bee-venom-derived interventions in clinical applications.
Highlights
Bee-venom acupuncture (BVA) has been widely applied to various disorders including pain-related diseases; patients are often warned of adverse reactions such as anaphylaxis
The data source was the electronic medical records (EMRs) of 66,614 subjects who had visited the pain-spine center and rehabilitation center in Dunsan Hospital of Daejeon University, South Korea, from January 2010 to March 2019. This process was conducted via integrated hospital information system (IHIS) that analyzed the order communication system (OCS) and Electronic medical record (EMR)
The inclusion criteria for the selection of patients and the incidence of a hypersensitivity reaction were as follows: 1) subjects who had been treated with BVA at least once, as recorded in their EMRs; or 2) subjects who complained of a BVA-related systemic allergic reaction with/without the prescription of anti-allergic drugs such as antihistamines, adrenaline, or adrenal cortex hormones
Summary
Bee-venom acupuncture (BVA) has been widely applied to various disorders including pain-related diseases; patients are often warned of adverse reactions such as anaphylaxis. Beevenom is an effective therapeutic for other challenging disorders, including incurable skin disease, cancer, and Parkinson’s disease (Hartmann et al, 2016; Gu et al, 2018; Aufschnaiter et al, 2020). Despite these potential applications, the clinical use of bee-venom is limited due to allergic reactions, including lifethreatening responses such as anaphylaxis. Another study presented incidence rates of 0.48% for hypersensitivity reactions and 0.01% for anaphylaxis from 9,528 MRI examinations with contrast-agent (Li et al, 2006)
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