Acute renal failure after massive honeybee stings

Abstract

SUMMARYTwo clinical cases of patients who survived after numerous attacks of Africanized bees (600 and 1500 bee stings, respectively) are reported. Clinical manifestation was characterized by diffuse and widespread edema, a burning sensation in the skin, headache, weakness, dizziness, generalized paresthesia, somnolence and hypotension. Acute renal failure developed and was attributed to hypotension, intravascular hemolysis, myoglobinuria due to rhabdomyolysis and probably to direct toxic effect of the massive quantity of injected venom. They were treated with antihistaminic, corticosteroids and fluid infusion. One of them had severe acute renal failure and dialysis was required. No clinical complication was observed during hospital stay and complete renal function recovery was observed in both patients. In conclusion, acute renal failure after bee stings is probably due to pigment nephropathy associated with hypovolemia. Early recognition of this syndrome is crucial to the successful management of these patients.

Cardiovascular profile after intravenous injection of Africanized bee venom in awake rats

“…These substances may provoke ischemia in the myocardium, as well as intense hypotension 18 . There are reports of changes in arterial pressure, hypertension have been described as part of the "autonomic storm" 3,9,16,19,25 , and especially hypotension, in human victims of multiple Africanized bee stings 6,9,22 , as well as acute myocardial infarction (AMI) 13,18 . Delayed reactions occurring only 18 h after envenomation have also been reported, with a rapid course and multiple organ failure 16 .…”

“…Human victims of multiple stings manifest hemolysis, rhabdomyolysis, cardiotoxicity and acute renal failure (ARF) due to acute tubular necrosis (ATN), as well as changes in arterial pressure, hypotension 6,9,18,22 and hypertension 3,9,16,19,25 .…”

Massive Envenomation by Bees Sting in a Child in Togo

“…Between 250 and 500 bites, death can occur in adults but deaths have already been recorded from thirty simultaneous bites [3]. In the literature some rare cases of survival after massive bites have been described [9]. The risk of an acute renal failure is real from 100 stings because of the hemolysis induced by the venom.…”

Acute Kidney Injury Induced by Snake and Arthropod Venoms

“…Envenomed patients commonly have anuria or oliguria, high levels of serum creatinine (10-30 mg/dL) and CK (>2,000 U/L), hypotension, tachycardia, myocardial damage and anemia (Daher et al, 2003;Gabriel et al, 2004;França et al, 1994;Xuan et al, 2010). Acute tubular necrosis is the main histologic finding in human beings, domestic dogs, and in experimental animals after bee and wasp envenomations.…”