Clinical Features of Severe Wasp Sting Patients with Dominantly Toxic Reaction: Analysis of 1091 Cases

Xie, Cuihong; Xu, Shabei; Ding, Feng; Xie, Mingxing; Lv, Jiagao; Yao, Jianchu; Pan, Dengji; Sun, Qian; Liu, Chenchen; Chen, Tie; Li, Shusheng; Wang, Weixu

doi:10.1371/journal.pone.0083164

Cited by 100 publications

(126 citation statements)

References 19 publications

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“…However, only a few studies have reported the use of blood purification for venom-induced MODS treatment. In the medical literature, the largest case series reporting the treatment with blood purification on venom-induced MODS included 119 patients [2] . Notably, there was no data regarding the effect of blood purification on mortality or disease progression of venom-induced MODS.…”

Section: Discussionmentioning

confidence: 99%

“…In developed countries, almost all patients who have suffered from a single or a few stings have had IgE-mediated allergic reactions of different degrees [1] . Thus, it is rare for them to develop renal failure and MODS [2] . In such cases, treatment is centered on controlling the allergic reaction and desensitization [3,4] .…”

Section: Introductionmentioning

confidence: 99%

“…The mechanisms underlying wasp sting injury may comprise the direct toxic effect of venom and immune inflammatory reaction to venom composi-tion. This immune inflammatory reaction involves both cellular (lymphocytes) and humoral (IgE and cytokines) immunity [2] .…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Two Combinations of Blood Purification Techniques for the Treatment of Multiple Organ Failure Induced by Wasp Stings

Yuan¹,

Chen²,

Hu³

et al. 2016

Blood Purif

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Background/Aims: The aim of this study was to explore the clinical efficacy of 2 combinations of blood purification techniques in patients with sting venom-induced multiple organ dysfunction syndrome (MODS). Methods: A total of 23 patients received 35 sessions of hemoperfusion (HP) + continuous veno-venous hemodiafiltration (CVVHDF) treatment and 22 sessions of plasma exchange (PE) + CVVHDF treatment, respectively. Results: Both HP + CVVHDF and PE + CVVHDF reduced the levels of inflammation, thus improving our patients' health condition. Moreover, PE + CVVHDF was found to be significantly more effective in reducing the levels of specific liver function markers and inflammatory mediators, as well as shortening prothrombin time and increasing the levels of serum albumin. Conclusion: Both combinations of blood purification techniques were capable of improving MODS. However, the PE + CVVHDF approach was more efficient for the removal of wasp venom and inflammatory mediators from the blood.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of Two Combinations of Blood Purification Techniques for the Treatment of Multiple Organ Failure Induced by Wasp Stings

Yuan¹,

Chen²,

Hu³

et al. 2016

Blood Purif

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“…Bee and wasp stings are common insults for CA-AKI in Asia, especially in regions of Southern China, India, Nepal, and Vietnam [43,44,45,46]. One or two stings cause just a local allergic reaction, but massive attacks with hundreds to thousands of stings cause severe systemic symptoms, affecting different organs with a high mortality.…”

Section: Causes and Patterns Of Aki In Asiamentioning

confidence: 99%

Acute Kidney Injury in Asia

Yang¹

2016

Kidney Dis

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Background: Acute kidney injury (AKI) is a common disorder and is associated with a high morbidity and mortality worldwide. The diversity of the climate and of the socioeconomic and developmental status in Asia has a great influence on the etiology and presentation of AKI in different regions. In view of the International Society of Nephrology's 0by25 initiative, more and more attention has been paid to AKI in Asian countries. Summary: In this review, we summarize the recent achievements with regard to the prevalence and clinical patterns of AKI in Asian countries. Epidemiological studies have revealed the huge medical and economic burden of AKI in Eastern Asian countries, whereas the true epidemiological picture of AKI in the tropical areas is still not well understood. In high-income Asian regions, the presentation of AKI resembles that in other developed countries in Europe and North America. In low-income regions and tropical areas, infections, environmental toxins, and obstetric complications remain the major culprits in most cases of AKI. Preventive opportunities are missed because of failure to recognize the risk factors and early signs of AKI. Patients often present late for treatment or are recognized late by physicians, which leads to more severe kidney injury, multiorgan involvement, and increased mortality. There is significant undertreatment of AKI in many regions, and medical resources for renal replacement therapy are not universally available. Key Messages: More efforts should be made to increase public awareness, establish preventive approaches in communities, educate health-care practitioner entities to achieve better recognition, and form specialist renal teams to improve the treatment of AKI. The choice of renal replacement therapy should fit patients' needs, and peritoneal dialysis can be practiced more frequently in the treatment of AKI patients. Facts from East and West: (1) More than 90% of the patients recruited in AKI studies using KDIGO-equivalent criteria originate from North America, Europe, or Oceania, although these regions represent less than a fifth of the global population. However, the pooled incidence of AKI in hospitalized patients reaches 20% globally with moderate variance between regions. (2) The lower incidence rates observed in Asian countries (except Japan) may be due to a poorer recognition rate, for instance because of less systematically performed serum creatinine tests. (3) AKI patients in South and Southeastern Asia are younger than in East Asia and Western countries and present with fewer comorbidities. (4) Asian countries (and to a certain extent Latin America) face specific challenges that lead to AKI: nephrotoxicity of traditional herbal and less strictly regulated nonprescription medicines, environmental toxins (snake, bee, and wasp venoms), and tropical infectious diseases (malaria and leptospirosis). A higher incidence and less efficient management of natural disasters (particularly earthquakes) are also causes of AKI that Western countries are less likely to...

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“…Wasp stings can cause a variety of symptoms such as local reactions including swelling, redness, heat and pain, and severe wasp venom absorption, can cause fever, dizziness, coma, failure of the heart, liver, kidneys, and even death [1,2]. We performed a retrospective study of 158 patients with wasp stings treated at our hospital from April to November 2014.…”

Section: Introductionmentioning

confidence: 99%