Supplemental Bee Pollen Ingestion With Resultant Anaphylaxis and Allergic Asthma: Case Report

Bee pollen has become an increasingly popular dietary supplement due to potential therapeutic effects. However, ingestion has been shown to trigger allergic responses as severe as anaphylaxis. This case highlights allergic asthma development in a 26-year-old female patient with subsequent anaphylaxis secondary to bee pollen ingestion. This patient presented to the emergency department with complaints of lip and tongue swelling, dyspnea, nausea, abdominal pain, and itching 4 h after bee pollen ingestion. Her medical history included seasonal allergic rhinitis and prior exercise-induced asthma that had not required treatment for 10 years. She was treated with a standard anaphylaxis pharmacological regimen and discharged. The patient then began to experience dyspnea and wheezing 1 month later during peak fall pollen levels. On allergy testing, the patient's total serum immunoglobulin E (IgE) was elevated at 189 kU/L. She also had elevated specific IgE to common ragweed, mugwort, and cocklebur, which are prominent allergens in the fall. Given the timing of onset of new symptoms, partial relief with an inhaled short-acting B2 agonist, and no pertinent findings for other causes, the patient was subsequently diagnosed with allergic asthma secondary to bee pollen ingestion. Although anaphylaxis to bee pollen is rare, it is becoming increasingly reported in literature and demonstrates an adverse effect that can occur when proper regulation and education are not performed. Dietary supplements like bee pollen need to have further testing and contain more thorough warnings on labels to decrease adverse events and protect people from undue harm.