Kurmana Manoj Kumar, Kumhar Maniram, Tiwari Ravindra Kumar, Tak Harsh
Internal Medicine, Jawaharlal Nehru Medical College Ajmer, Ajmer, IND.
Cureus. 2024 Jul 6;16(7):e63938. doi: 10.7759/cureus.63938. eCollection 2024 Jul.
This study delves into the rare occurrence of rhabdomyolysis induced by wasp stings, emphasizing its toxic systemic repercussions. Drawing parallels with documented instances of insect bites worldwide, including those by honey bees and Africanized bees, the research explores the correlation between multiple wasp stings and acute renal failure associated with rhabdomyolysis. The venom's active components, such as amines, kinins, and histamine-releasing peptides, underpin toxic systemic reactions, leading to hemolysis, coagulopathy, and severe cytotoxicity-induced acute renal failure. Noteworthy is the emergence of blackish necroses at the sting site, suggesting intense cytotoxicity. The study also highlights skin necrosis as a prognostic indicator for toxic systemic reactions. The presented case manifests an anaphylaxis-like reaction, revealing insights into toxic responses devoid of IgE-mediated allergic reactions. Timely intervention, encompassing hydration, transfusion, and dialytic support, proves imperative in scenarios involving multiple wasp stings, offering successful outcomes documented through plasma exchange in severe cases. This research prompts considerations beyond anaphylaxis, urging exploration of severe toxic systemic reactions in the context of multiple wasp stings.
本研究深入探讨黄蜂蜇伤引起横纹肌溶解的罕见情况，强调其毒性全身影响。该研究将其与全球有记录的昆虫叮咬案例（包括蜜蜂和非洲化蜜蜂的叮咬）进行对比，探究多次黄蜂蜇伤与横纹肌溶解相关的急性肾衰竭之间的关联。毒液的活性成分，如胺类、激肽和组胺释放肽，是毒性全身反应的基础，可导致溶血、凝血病和严重细胞毒性诱导的急性肾衰竭。值得注意的是，蜇伤部位出现黑色坏死，提示有强烈的细胞毒性。该研究还强调皮肤坏死是毒性全身反应的预后指标。所呈现的病例表现出类似过敏反应的症状，揭示了无IgE介导的过敏反应的毒性反应。在多次黄蜂蜇伤的情况下，包括补液、输血和透析支持在内的及时干预至关重要，严重病例通过血浆置换记录了成功的治疗结果。这项研究促使人们考虑除过敏反应之外的情况，敦促在多次黄蜂蜇伤的背景下探索严重的毒性全身反应。
