Unusual Case of Anuria Due to African Bee Stings

Beccari, M.; Castiglione, Aldo; Cavaliere, G; d’Aloya, Gaetana; Fabbri, Carola; B, Losi; Ranzini, C; Romagnoni, Giovanni; Sorgato, G

doi:10.1177/039139889201500505

Cited by 16 publications

(6 citation statements)

References 7 publications

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“…Finally, the reports of human victims of multiple Afri canized bee stings that developed ARF [4][5][6][7][8] suggest that the physiopathogénie mechanisms of renal damage may show some parallelism with the results of the present study. Thus, the present information may be of help in terms of clinical conduct based on the indication of complementary tests or the monitoring of one of the target organs involved.…”

Section: Discussionsupporting

confidence: 76%

Renal Changes Induced by Envenomation with Africanized Bee Venom in Female Wistar Rats

Reis

Costa²,

Coimbra³

et al. 1997

Kidney Blood Press Res

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Human envenomation caused by bee or wasp stings has been reported to cause acute renal failure (ARF), usually due to acute tubular necrosis (ATN), as a frequent complication. The pathogenetic mechanisms of ATN occurring in these accidents are still unclear. In the present study, female Wistar rats weighing 150-200 g were injected intravenously with Africanized bee venom at a dose of 0.4 µl/l00 g body weight and used in functional and light microscopy studies. The animals were divided into two groups: the early group was studied 3-8 h after inoculation, and the late group was studied 24-30 h thereafter. The animals showed ARF characterized by reduction of glomerular filtration rate with increasing levels of plasma creatinine. They also showed increased fractional sodium and potassium excretions, suggesting changes in the proximal portion of the nephron. The water transport through collecting tubules was reduced, with consequent diuresis, indicating functional changes in the distal portion of the nephron. These functional changes were more marked in the early group, with recovery tending to occur after 24 h. Albuminuria was also observed in this group. Light microscopy showed ATN mainly in cortex and outer medulla, with isolated necrosis in cells or small groups of cells and cast formation in the distal and collecting tubules. After 24 h frequent mitotic figures were found in the tubular epithelium. The observed ARF was due to ATN which in turn was probably caused by multiple effects, mainly hemodynamic changes secondary to cardiotoxicity and systemic vasodilation caused by the venom, myohemoglobinuria, and the direct action of the venom on tubular cells.

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Section: Discussionsupporting

confidence: 76%

Renal Changes Induced by Envenomation with Africanized Bee Venom in Female Wistar Rats

Reis

Costa²,

Coimbra³

et al. 1997

Kidney Blood Press Res

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“…There are several studies about the effects of honeybee venom in human organism 1,3,4,15,16 . The incidence of anaphylaxis caused by insect stings has been estimated from 0.3 to 3% in the general population 15 .…”

Section: Introductionmentioning

confidence: 99%

Acute renal failure after massive honeybee stings

Daher

Silva

Bezerra

et al. 2003

Rev. Inst. Med. trop. S. Paulo

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SUMMARYTwo clinical cases of patients who survived after numerous attacks of Africanized bees (600 and 1500 bee stings, respectively) are reported. Clinical manifestation was characterized by diffuse and widespread edema, a burning sensation in the skin, headache, weakness, dizziness, generalized paresthesia, somnolence and hypotension. Acute renal failure developed and was attributed to hypotension, intravascular hemolysis, myoglobinuria due to rhabdomyolysis and probably to direct toxic effect of the massive quantity of injected venom. They were treated with antihistaminic, corticosteroids and fluid infusion. One of them had severe acute renal failure and dialysis was required. No clinical complication was observed during hospital stay and complete renal function recovery was observed in both patients. In conclusion, acute renal failure after bee stings is probably due to pigment nephropathy associated with hypovolemia. Early recognition of this syndrome is crucial to the successful management of these patients.

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“…The amines include acetylcholine, histamine, serotonin and catecholamines (adrenaline, noradrenaline and dopamine). The proteins and polypeptides are primarily kinins and enzymes, including phospholipase A and B, proteases, hyaluronidase and a mast‐cell degranulating peptide, mastoporan 17–34 . Specific toxins (the haemolytic, neurotoxic Orientotoxin 1 ) and a glucagon‐like factor 1 have been reported.…”

Section: Discussionmentioning

confidence: 99%

Massive European wasp envenomation of a child

Levick

Braitberg

1996

Emergency Medicine

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Envenomation is a unique area of emergency medicine which interfaces acute emergency care with zoological research and public education. A considerable amount is known about envenomation by the snakes and spiders of Australia, which are among the most venomous in the world. There is little known, however, about massive envenomation by the European wasp (species Vespula germanica, family Vespidae), a recently introduced, aggressive and venomous vespid wasp. Allergy to bee, wasp and ant venom (order Hymenoptera) is well reported in the literature but there has been no documentation of systemic allergic reactions following massive vespid envenomation. Massive envenomation by vespid wasps in Australia has not been reported, although there are international reports of serious morbidity and a number of fatalities. This paper reports a massive European wasp envenomation in Melbourne and reviews the international literature. In this case, in contrast to the literature on massive vespid wasp envenomation, there is predominance of central nervous system toxicity with no major metabolic disturbance. The management of massive vespid envenomation includes standard supportive care and close laboratory monitoring for early evidence of haemolysis, rhabdomyolysis and metabolic derangement, which may significantly precede any clinical deterioration. Serious complications may be delayed and it is advised to follow up patients for 72 hours. There is potential for further research into vespid wasp venom and a need for increased public awareness of preventative strategies in Australia.

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Unusual Case of Anuria Due to African Bee Stings

Cited by 16 publications

References 7 publications

Renal Changes Induced by Envenomation with Africanized Bee Venom in Female Wistar Rats

Renal Changes Induced by Envenomation with Africanized Bee Venom in Female Wistar Rats

Acute renal failure after massive honeybee stings

Massive European wasp envenomation of a child

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