Acute Renal Failure Due to Multiple Stings by Africanized Bees

Mejia, Gonzalo; Arbelaez, Mario; Henao, Jorge; Sus, Alvaro A.; Arango, Jorge Luis Parra

doi:10.7326/0003-4819-104-2-210

Cited by 61 publications

(48 citation statements)

References 4 publications

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“…Acute renal failure in these patients is likely to be secondary to arterial hypotension due to direct vasoactive toxic effect of the venom, hemoglobinuria due to intravascular hemolysis and myoglobinuria due to rhabdomyolysis. Clinical evidence suggests that some bee toxins may directly damage renal tubule 5,7,10,17 . The association between rhabdomyolysis and acute renal failure is well known.…”

Section: Discussionmentioning

confidence: 99%

“…Accidents involving venomous animals are very common in the State of Ceará, northeast of Brazil (data from CEATOXToxicological Center of Ceará). The Africanized bee attacks are characteristically massive, and, excluding the cases of anaphylaxis, the injected venom intensity and the prognosis are directly associated with the number of bee stings 2,3,10,11 . It has been observed that multiple bee stings are capable of causing death, in an adult man, which is probably due to a direct toxic effect of the venom 5,7 .…”

Section: Introductionmentioning

confidence: 99%

“…Several cases of death due to massive insect stings have been reported, and the mortality rates has been estimated from 15 to 25 percent 3,9,10,11,17,19 . The cause of death was not described in most cases.…”

mentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute renal failure after massive honeybee stings

Daher

Silva

Bezerra

et al. 2003

Rev. Inst. Med. trop. S. Paulo

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“…Em uma revisão de 24 casos de envenenamento por picadas de abelhas, observou-se hemólise e rabdomiólise em 14 e 11 dos casos avaliados, respectivamente 7 . Na literatura, dois relatos de casos de duas crianças picadas cerca de 800 e 500 vezes, respectivamente, evoluíram com rabdomiólise 11 e IRA 8 com recuperação da função renal após diálise peritoneal, porém na maioria dos casos a evolução não é satisfatória para adultos com mais de 500 picadas, mesmo na vigência de tratamento dialítico 1 2 7 12 14 , sendo a mortalidade média nesses casos em torno de 20% 7 14 .…”

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Insuficiência renal aguda por picada de abelhas: relato de casos

Daher

Oliveira

Silva

et al. 2009

Rev. Soc. Bras. Med. Trop.

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As abelhas africanizadas surgiram no Brasil, na década de cinqüenta, originadas de um laboratório de apicultura que realizou a hibridização de abelhas africanas, trazidas da África, com as européias já existentes na natureza brasileira, naquela época. Caracterizam-se por serem muito agressivas, atacando suas vítimas de forma maciça, em enxames, inoculando grande quantidade de veneno 2 9 . Nos casos de múltiplas picadas tem sido observada, além dos casos de anafilaxia, a capacidade de causar danos devido ao efeito tóxico direto do veneno, por exemplo insuficiência renal aguda, bem como a morte 1 2 7 9 12 14 .A insuficiência renal aguda (IRA) é caracterizada por uma deterioração na função renal que acontece no decorrer de horas a dias, resultando na falência dos rins em excretar produtos nitrogenados e em manter o equilíbrio hidroeletrolítico e ácido-básico 13 16 .A rabdomiólise é uma síndrome caracterizada por lesão muscular extensa com liberação de inúmeras substâncias intracelulares na circulação, podendo ser causada por trauma ABSTRACTRhabdomyolysis is a syndrome characterized by muscle injury, most frequently due to muscle crushing and trauma. However, it may also be induced by non-traumatic causes, for example by means of stinging by Africanized bees. We describe two cases of rhabdomyolysis that presented dialytic acute renal failure after several bee stings.

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“…Serial blood chemistry studies and serum levels of haemoglobin and myoglobin performed over a period of hours to days will reveal whether toxic venom effects have occurred. The renal damage, as seen in this report, could be as a result of either direct nephrotoxicity due to toxin, 4 hypotension leading to ischemic tubular necrosis 5 or nephropathy due to haemoglobinuria and myoglobinuria. 6 Direct toxin mediated cellular damage in massive envenomation has also been found to cause disseminated intravascular coagulopathy, cardiovascular abnormalities, 7 hepatic damage 8 and neurological deficits of different degrees.…”

Section: Discussionmentioning

confidence: 94%

A Call for sting treatment protocol: Case report of a 3 year old with massive bee sting resulting in acute kidney injury

Jimoh¹,

Akuse²,

Bugaje³

et al. 2016

Nig. J. Paed.

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Acute Kidney Injury in children following bee sting envenomation is rare and survival is hinged on early recognition and prompt appropriate management. This report is aimed at raising awareness among healthcare workers, of one of the systemic effects of massive bee sting and the need to develop sting treatment protocol. A three year old preschooler was attacked by a swarm of bees, receiving over 150stings. Initial clinical features were allergic response involving the head, face and tongue for which he had first aid in a primary healthcare facility and thereafter sent home. Few hours later he developed clinical features of intravascular haemolysis, rhabdomyolysis, hypertension and acute renal failure. Laboratory findings were in keeping with clinical presentation. Despite supportive management, serum biochemistry worsened necessitating haemodialysis. Massive bee sting envenomation can cause systemic reactions and organ dysfunctions. To improve the overall clinical outcome, sting treatment protocol is advocated.

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Acute Renal Failure Due to Multiple Stings by Africanized Bees

Cited by 61 publications

References 4 publications

Acute renal failure after massive honeybee stings

Acute renal failure after massive honeybee stings

Insuficiência renal aguda por picada de abelhas: relato de casos

A Call for sting treatment protocol: Case report of a 3 year old with massive bee sting resulting in acute kidney injury

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