Wasp envenomation-induced acute renal failure: a report of three cases |
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Authors: | Vikrant Sanjay Pandey Deveshwar Machhan Prem Gupta Dalip Kaushal Surinder Singh Grover Neelam |
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Affiliation: | Department of Nephrology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. sanjayvikrant@rediffmail.com |
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Abstract: | Acute renal failure is an unusual complication of wasp stings. We report three cases who developed acute renal failure after multiple wasp stings (Vespa magnifica). Two patients had evidence of intravascular haemolysis and rhabdomyolysis whereas one patient investigation showed no evidence of intravascular haemolysis or rhabdomyolysis. All three cases had impaired liver functions. Oligo-anuria was seen in all three of the patients and all of them required dialytic support. One patient died of massive gastrointestinal bleeding while the remaining two recovered completely. Although acute renal failure after wasp stings is typically caused by acute tubular necrosis in the setting of haemolysis or rhabdomyolysis, in some patients, renal failure may result from a direct nephrotoxic effect or acute interstitial nephritis from a hypersensitivity reaction to the wasp venom. |
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Keywords: | acute interstitial nephritis acute renal failure acute tubular necrosis haemolysis hymenoptera stings rhabdomyolysis wasp envenomation wasp stings |
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