Acute tubulointerstitial nephritis following hymenopteran stings

Ezhilnilavan, S; Priyamvada, P S; Srinivas, Bheemanathi Hanuman; Haridasan, Satish; Parameswaran, Sreejith

doi:10.1136/postgradmedj-2018-135608

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2019

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“…AKI is due to direct toxic effect of the venom, ischemic acute tubular injury, and nephropathy due to hemoglobinuria and rhabdomyolysis. Renal biopsy reveals acute tubular necrosis and occasionally acute interstitial nephritis and pigment tubulopathy [6,11,12]. Liver injury is rare [5] and the pathogenesis has not been well understood.…”

Section: Discussionmentioning

confidence: 99%

A Case of Multiple Wasp Stings Causing Multi-organ Dysfunction Syndrome

Basnet¹,

Pantha²,

Acharya³

et al. 2019

TOUNJ

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Wasp stings occur commonly and uncomplicated cases are generally managed at local health centers. Complicated cases are referred to tertiary hospitals for multi-specialty care. We report a case of a 30-year old gentleman from a remote center in Nepal who had multiple wasp stings and developed oligo-anuric acute kidney injury, liver failure, and rhabdomyolysis. He was promptly referred to our hospital after initial resuscitation. At our hospital, he was treated with intensive conventional supportive care and specific organ-supportive care including N-Acetylcysteine infusion and hemodialysis. With the treatment given, the general condition of the patient as well as liver function improved within the first week. However, the recovery of kidney function and urine output lagged behind. The patient showed signs of improvement in kidney function at the end of the third week and completely recovered by the 40th day of treatment.

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Section: Discussionmentioning

confidence: 99%