Bee venom: an unusual cause of acute kidney injury

IF 0.7 4区医学 Q4 UROLOGY & NEPHROLOGY Nephrologie & Therapeutique Pub Date : 2023-04-26 DOI:10.1684/ndt.2023.19

Aboubacar Sidiki Fofana, Magara Samaké, Seydou Sy, Sah Dit Baba Coulibaly, Abdoulaye Cissé, Moctar Coulibaly, Modi Sidibé, Bakary Sayon Keita, Hamadoun Yattara, Saharé Fongoro

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Abstract

Introduction: Bee sting venom is generally well tolerated. However, some rare cases of massive stings can lead to anaphylactic shock and even renal failure. This observation is the illustration of a case of acute kidney injury secondary to bee stings in a 64-year-old black african subject.

Case presentation: A 64-year-old man without a known medical history was referred to the emergency department of the Fousseyni Daou hospital in Kayes (Mali) for disturbed consciousness 4 hours after massive stings from a bee swarm. Renal failure with serum creatinine level at 752,2 µmol/L was documented on day 3 in a context of total anuria. The patient was transferred to a nephrology unit and biology confirmed renal failure associated with intravascular haemolysis and rhabdomyolysis. The kidneys were of normal size and well differentiated. The diagnosis of severe acute kidney injury due to massive envenomation induced by bee venom was evoked. The evolution was favourable, with normalization of renal function at D26 after 5 sessions of haemodialysis in parallel with transfusions of packed red blood cells.

Conclusion: A massive bee attack should be considered a medical emergency because of the organic damage it can inflict. The renal prognosis depends on the number of stings, and especially on the delay and the quality of the treatment. Early initiation of dialysis treatment reduces mortality.

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蜂毒:急性肾损伤的不寻常原因

导读:蜂螫毒液一般耐受良好。然而，在一些罕见的情况下，大量的蜇伤会导致过敏性休克，甚至肾功能衰竭。这一观察是一个病例的急性肾损伤继发于蜜蜂蜇伤在一个64岁的非洲黑人受试者说明。病例介绍:一名没有已知病史的64岁男子在被蜂群大量蜇伤4小时后，因意识紊乱被转介到Kayes(马里)Fousseyni Daou医院急诊科。在全无尿的情况下，第3天记录了肾功能衰竭，血清肌酐水平为752,2µmol/L。患者被转移到肾病科，生物学证实肾功能衰竭与血管内溶血和横纹肌溶解有关。肾脏大小正常，分化良好。唤起对蜂毒大量中毒致严重急性肾损伤的诊断。演进是有利的，在5次血液透析并输注填充红细胞后，D26时肾功能恢复正常。结论:大规模的蜜蜂袭击应被视为医疗紧急情况，因为它可以造成有机损伤。肾脏的预后取决于蜇伤的次数，尤其是治疗的延迟和质量。早期开始透析治疗可降低死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nephrologie & Therapeutique 医学-泌尿学与肾脏学

CiteScore

0.80

自引率

14.30%

发文量

485

审稿时长

11.9 weeks

期刊介绍： Organe d''expression de la Société de Néphrologie, de la Société Francophone de Dialyse et de la Société de Néphrologie Pédiatrique, Néphrologie et Thérapeutique a pour vocation de publier des textes en français dans le domaine de la Néphrologie, qu''il s''agisse d''actualisation des connaissances, de recommandations de bonne pratique clinique, de publications originales, ou d''informations sur la vie des trois sociétés fondatrices. La variété des thèmes abordés reflète la richesse de la Néphrologie, qu''il s''agisse d''aspects fondamentaux issus de la physiologie, de l''immunologie, de l''anatomo-pathologie, ou de la génétique, ou de sujets de néphrologie clinique, notamment ceux en rapport avec les thérapeutiques néphrologiques, transplantation, hémodialyse et dialyse péritonéale.

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