Rachaiah Niranjan M, Jayappagowda Lokesh A, Siddabyrappa Harsha B, Bharath Venkatesh K
Department of Medicine, Hassan Institute of Medical Sciences, Hassan, Karnataka, India.
N Am J Med Sci. 2012 Feb;4(2):104-6. doi: 10.4103/1947-2714.93380.
The wasp stings usually cause local reactions and rarely anaphylaxis. However the multiple wasp stings may cause multisystem involvement. We report a case of acute renal failure (ARF) following multiple wasp stings. A middle aged healthy gentleman presented with pain and swelling of the upper part of the body following multiple wasp stings. After 2 days, he developed progressive decrease in urine output with high colored urine. Physical examination revealed the edematous and tender affected part. On investigating, it was found to have sequential elevations in renal function tests. The markers of muscle injury were grossly elevated and liver enzymes were deranged. These findings suggest multisystem involvement predominantly ARF secondary to rhabdomyolysis. With the initiation of the intense hemodialysis, all the above parameters became normal. Timely intervention of multiple wasp stings causing ARF with multiorgan involvement by hemodialysis not only prevents mortality but also other complications.
黄蜂蜇伤通常会引起局部反应，很少会导致过敏反应。然而，多次黄蜂蜇伤可能会导致多系统受累。我们报告一例多次黄蜂蜇伤后发生急性肾衰竭（ARF）的病例。一名中年健康男性在多次黄蜂蜇伤后出现身体上部疼痛和肿胀。两天后，他出现尿量逐渐减少，尿液颜色加深。体格检查发现受影响部位水肿且压痛。检查发现肾功能检查结果呈进行性升高。肌肉损伤标志物大幅升高，肝功能酶也紊乱。这些发现提示多系统受累，主要是横纹肌溶解继发的急性肾衰竭。随着强化血液透析的开始，上述所有参数均恢复正常。通过血液透析及时干预多次黄蜂蜇伤导致的急性肾衰竭并伴有多器官受累，不仅可预防死亡，还可预防其他并发症。
