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

Abstract

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

Acute Kidney Injury Following Wasp Stings - A Case Report and Literature Review

“…There were many case series of acute kidney injury without evidence of shock, haemolysis or rhabdomyolysis which were found to be due to acute interstitial nephritis on renal biopsy 18,19 .…”

“…Acute interstitial nephritis can be treated with steroid 18,19,21 . Steroid reduces interstitial fibrosis in acute interstitial nephritis helping early renal recovery and ultimately preventing irreversible kidney damage 20 .…”

Acute kidney injury due to multiple wasp stings in an eightyear- old child

“…Acute kidney injury is usually reversible with recovery varying from few days to weeks and most of the patients recover within a month's time 1,4,12,14 . Renal biopsy is recommended when renal function is deteriorating or not improving to detect renal lesion as that determines specific drug treatment 13 .…”

“…Renal biopsy is recommended when renal function is deteriorating or not improving to detect renal lesion as that determines specific drug treatment 13 . Acute interstitial nephritis can be treated with steroid [11][12][13][14] . Steroid reduces interstitial fibrosis in acute interstitial nephritis helping early renal recovery and ultimately preventing irreversible kidney damage 13 .…”

“…The earlier case reports of acute kidney injury without evidence of haemolysis and rhabdomyolysis were thought to be due to direct cytotoxic effects of different constituents of venom on nephrons but renal biopsies were not done to ascertain the diagnosis 10 . Subsequently there were many case series of acute kidney injury without evidence of shock, haemolysis or rhabdomyolysis which were found to be due to acute interstitial nephritis on renal biopsy 11,12 .…”