Frontal Lobe Like Syndrome Due To Bee Sting

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dc.contributor.authorGokmen, Nihal Mete
dc.contributor.authorEvyapan Akkus, Dilek
dc.contributor.authorGulluoglu, Halil
dc.contributor.authorJara, Maria
dc.contributor.authorSanchez, Laura
dc.contributor.authorOzsan, Nazan
dc.contributor.authorDonmez, Ayhan
dc.contributor.authorEscribano, Luis
dc.contributor.authorGokmen, Erhan
dc.date.accessioned2019-10-27T22:05:41Z
dc.date.available2019-10-27T22:05:41Z
dc.date.issued2014
dc.departmentEge Üniversitesien_US
dc.description.abstractA 34 year-old male beekeeper experienced flushing, breathing difficulty and loss of consciousness five minutes after he got stung by a honeybee. He was admitted to a local emergency room with hypotension and a phyliform pulse. After a 24-hour period of unresponsiveness, the patient gained consciousness and was discharged home. Two weeks later however, the patient presented with slowing of speech, personality and behavioral changes and difficulty in resolving personal needs such as dressing. Neuropsychological assessment revealed deficits in attention, concentration, executive function, recall memory, organization and coordination and slurred speech. Cranial MRI revealed marked symmetrical hyperintense lesions involving bilateral lentiform and caudate nuclei. Skin prick tests to hymenoptera species were negative. Specific IgE levels were also undetectable. The patient's baseline tryptase level was 49 ng/mL (normal <14.1 ng/ml). Bone marrow biopsy showed dense compact mast cell aggregates in CD117 (c-kit) and tryptase stained sections. Co-expression of CD25 and CD2 were identified on mast cells by flow cytometry. An activating somatic codon Asp816 -> Val KIT mutation was detected in mast cells but not in neutrophils. Based on these findings, diagnosis of systemic mastocytosis was made. This patient represents the first case in English literature who was diagnosed with sytemic mastocytosis and frontal lobe syndrome. Frontal lobe dysfunction may emerge with bilateral basal ganglia lesions. Mast cell degranulation has been documented to enhance vascular permeability and to regulate blood-brain barrier permeability. Besides probable hypoxic encephalopathy, the increased tendency for mast cells to undergo spontaneous degranulation can be explanatory for vasogenic edema in systemic mastocytosis.en_US
dc.identifier.endpage407en_US
dc.identifier.issn1302-1664
dc.identifier.issn1302-1664en_US
dc.identifier.issue2en_US
dc.identifier.startpage398en_US
dc.identifier.urihttps://hdl.handle.net/11454/48552
dc.identifier.volume31en_US
dc.identifier.wosWOS:000343369600021en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.language.isoenen_US
dc.publisherJournal Neurological Sciencesen_US
dc.relation.ispartofJournal of Neurological Sciences-Turkishen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBee stingen_US
dc.subjectbee venom allergyen_US
dc.subjectsystemic mastocytosisen_US
dc.subjectfrontal lobe syndromeen_US
dc.titleFrontal Lobe Like Syndrome Due To Bee Stingen_US
dc.typeArticleen_US

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