Acute myocardial infarction following wasp sting

Levine, Harold D.

doi:10.1016/s0002-8703(76)80222-0

Cited by 93 publications

(23 citation statements)

References 36 publications

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“…One patient with persistent hypotension developed transient electrocardiographic changes consistent with inferior myocardial wall ischemia. The electrocardiographic changes have been noted by previous investigators who have documented persistent electrocardiographic changes occurring in healthy individuals after anaphylaxis regardless of the cause (4,5). There was no evidence of primary cardiac dysfunction.…”

Section: Discussionsupporting

confidence: 76%

“…There was no evidence of FIGURE 5 Mean systemic blood pressure and serum plasma histamine levels (venous) in the three patients with circulatory anaphylaxis. *, Histamine (ng/ml); A, mean systemic blood pressure (mm Hg).…”

Section: Resultsmentioning

confidence: 99%

“…Since these reactions are usually unexpected and occasionally fatal, opportunities to investigate systematically the detailed pathophysiology with controlled studies are exceedingly rare. Most of the available data concerning the pathophysiology and treatment ofhuman anaphylaxis are derived from anecodotal clinical case reports and postmortem studies (1)(2)(3)(4)(5).…”

mentioning

confidence: 99%

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Physiologic manifestations of human anaphylaxis.

Smith¹,

Kagey‐Sobotka²,

Bleecker³

et al. 1980

J. Clin. Invest.

352

141

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A B S T R A C T In the course of a controlled study to evaluate different forms of immunotherapy for subjects with insect-sting hypersensitivity, we observed 11 subjects who had systemic cutaneous urticarial reactions and 3 subjects who experienced systemic anaphylaxis. With the exception of tachyeardia, there were no cardiopulmonary changes in the subjects with urticaria, whereas the major manifestation of anaphylactic shock in the other three subjects was severe hypotension that was probably secondary to peripheral vasodilation. Significant abnormalities in gas exchange developed in two subjects. In one, bronchospasm precipitated a respiratory arrest followed by endotracheal intubation with mechanical ventilation. Although plasma histamine levels were not related to the development of cutaneous reactions, the plasma histamine levels correlated with the severity and duration of the cardiopulmonary changes observed during anaphylactic shock. The two subjects with the most severe shock showed evidence of intravascular coagulation characterized by a diminution of Factor V, Factor VIII, fibrinogen, and high molecular weight kininogen, as well as changes in components of the complement system. Standard therapy with epinephrine and fluids, usually recommended for the treatment of systemic anaphylaxis, did not immediately reverse either the hemodynamic or the respiratory abnormalities in the two subjects with the most severe

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Section: Discussionsupporting

confidence: 76%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Physiologic manifestations of human anaphylaxis.

Smith¹,

Kagey‐Sobotka²,

Bleecker³

et al. 1980

J. Clin. Invest.

352

141

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“…In most instances, insect stings are only followed by allergic reactions but sometimes intravascular hemolysis, rhabdomyolysis, thrombocytopenia [9], acute tubular necrosis, acute hepatic injury[10,11], and myocardial infarction [12] have been reported. Their venom is a concentrated mixtures of complicated active components, such as melittin, apamine, phospholipases, hyaluronidase, acid phosphatase, histamine, and kinin.…”

Section: Resultsmentioning

confidence: 99%

Acute tubulo-interstitial nephritis leading to acute renal failure following multiple hornet stings

et al. 2006

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BackgroundHornet stings are generally associated with local and occasionally anaphylactic reactions. Rarely systemic complications like acute renal failure can occur following multiple stings. Renal failure is usually due to development of acute tubular necrosis as a result of intravascular haemolysis, rhabdomyolysis or shock. Rarely it can be following development of acute tubulo-interstitial nephritis.Case presentationWe describe a young male, who was stung on face, head, shoulders and upper limbs by multiple hornets (Vespa orientalis). He developed acute renal failure as a result of acute tubulo-interstitial nephritis and responded to steroids.ConclusionRare causes of acute renal failure like tubulo-interstitial nephritis should be considered in a patient with persistent oliguria and azotemia following multiple hornet stings. Renal biopsy should be undertaken early, as institution of steroid therapy may help in recovery of renal function

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“…Coronary spasm or myocardial infarction can occur a er insect stings [15,16] and as a consequence of idiopathic anaphylaxis [17]. Moreover, patients with anaphylaxis may present profound myocardial depression presumably due to the negative inotropic e ects of mast cell-derived mediators [18].…”

Section: Introductionmentioning

confidence: 99%