Department of Pathology, Apollo Hospitals Jubilee Hills, Hyderabad, Telangana, India.
Ravi Chaitanya Kidney and Children's Hospital, Rajhamundry, Andhra Pradesh, India.
Indian J Pathol Microbiol. 2023 Jan-Mar;66(1):177-179. doi: 10.4103/ijpm.ijpm_981_21.
Bee stings usually result in mild allergic reactions; however, mass envenomation can cause severe complications such as rhabdomyolysis, hemolysis, shock, or multi-organ damage. Rhabdomyolysis can result in acute renal failure either by tubular obstruction by myoglobin casts or by direct cytotoxic injury. We present a case of a 12-year-old female child who presented with sudden onset anuria and hypertension following mass envenomation by bees. A renal biopsy was performed, the microscopic evaluation of which revealed tubular injury, with associated intratubular pigmented casts. The casts stained positive for myoglobin immunohistochemical stain, thus confirming a diagnosis of myoglobin cast nephropathy. The patient was given IV steroids and underwent seven sessions of hemodialysis, following which there was complete recovery of renal function.
被蜜蜂蜇伤通常会引起轻度过敏反应；然而，大量蜂蜇伤会导致严重并发症，如横纹肌溶解症、溶血性贫血、休克或多器官损伤。横纹肌溶解症可导致急性肾衰竭，原因可能是肌红蛋白管型阻塞肾小管，也可能是直接细胞毒性损伤。我们报告了一例 12 岁女性患儿，在大量蜜蜂蜇伤后突然出现少尿和高血压。进行了肾活检，显微镜检查显示肾小管损伤，伴有管腔内色素管型。管型免疫组化染色肌红蛋白阳性，因此确诊为肌红蛋白管型肾病。给予患者静脉注射类固醇，并进行了 7 次血液透析，随后肾功能完全恢复。
