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A Case of Honey Bee Bite(sting) Anemia in Dog.

1) Case History

Pomerian female Dog / 2 years old. Hb: 4 g/dL, PCV: 18%, having history of severe honey bee bite (multiple bee stings) leading to Jaundice.

2) Haematological Changes

  
Fig.1: Marked Roleux formation, Poikilocytosis & Polychromasia. Note the increased tendency of RBC's to roleux formation due to change in membrane charges or due to toxin induced membrane damage. Also note the marked regenerative response as sequel to hemolytic anemia.Fig.2: Regenerative Anemia. Note the presence of polychromatic & nucleated RBC's(metarubricyte stages) indicating regenerative response to hemolytic anemia.
  
Fig.3: Regenerative Anemia. Note the presence of polychromatic erythrocytes indicating regenerative response to hemolytic anemia.Fig.4: Regenerative Anemia, Roleux Formation & platelet Anisocytosis. Note the presence of regenerative response along with variation in platelet size due to activation. The platelets are activated and some having pseudopodia/ giant granular filamentous platelets.

3) Pathogenesis

The bee venom contains melittin (toxin) & phospholipase A2 (enzyme), which together disrupts the red cell membrane causing massive intravascular hemolysis/hemolytic anemia. The hemolytic reactions may be immediate or delayed type. In present case, clinicopathological findings like increased tendency of roleux formation and marked regenerative response indicates the acute hemolytic crisis. The other end stage clinical manifestations can be observed in these cases includes toxic hepatitis & renal failure.