Acute Renal Failure Following Scorpion Sting *

Abstract

Fifteen cases of acute renal failure follwoing scorpion sting were studied. The onset of disease was characterized by the occurrence of hemoglobinuria within 24 h of the sting. Most of the patients developed oliguria, edema, hemolytic anemia, and hemolytic jaundice. Renal failure developed within a few days after the sting, and in five patients was severe enough to need dialysis. The onset of diuresis in oliguric patients occurred between 6 and 21 days following the sting. Renal biopsies were possible in four cases and showed mesangial proliferation, variable degrees of tubular changes, and mild interstitial infiltration. The pathogenesis of acute renal failure in these patients is discussed

Paroxysmal Nocturnal Hemoglobinuria and Acute Kidney Injury: A Case Report

“…ısırıkları, bazı enfeksiyon (tifo, sıtma) ve ilaçlar (metildopa, rifampin), PNH ve egzersiz hemoglobinürisidir (7,8,(10)(11)(12)(13)(14)(15). Bunların dışında ve ABH birlikteliğinde ayırıcı tanıda multipl myelom, hemolitik üremik sendrom ve otoimmün hemolitik anemi-lupus nefriti birlikteliği sayılabilir.…”

Acute renal insuffciency after scorpion sting

“…Renal excretion of concentrated venom results in direct renal tubular damage leading to ATI [4]. Haemoglobin released following intravascular haemolysis also damages renal tubules.…”

“…Haemoglobin casts pack the tubules and interfere with the excretory functions, contributing to ARI [4]. Vomiting, cardiac failure and vascular dilatation secondary to inflammatorymediator release also contribute to ATI by hypovolaemia and hypotension [2,4]. When there is DIC/HUS microthrombi occlude intra renal blood vessels resulting in thrombotic microangiopathy, with acute ischemic glomerular damage, glomerular capillary endothelial cell swelling, narrowed capillary lumina and mesangial expansion/mesangiolysis.…”

“…Serotonin causes impaired blood flow through the afferent arterioles resulting in ischaemia of the glomeruli [4]. Haemoglobin casts pack the tubules and interfere with the excretory functions, contributing to ARI [4]. Vomiting, cardiac failure and vascular dilatation secondary to inflammatorymediator release also contribute to ATI by hypovolaemia and hypotension [2,4].…”

“…Haemoglobin released following intravascular haemolysis also damages renal tubules. Serotonin causes impaired blood flow through the afferent arterioles resulting in ischaemia of the glomeruli [4]. Haemoglobin casts pack the tubules and interfere with the excretory functions, contributing to ARI [4].…”