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一名黄蜂蜇伤患者罕见地同时出现急性肾小管坏死和慢性肾小球硬化。

A rare concurrence of acute tubular necrosis and chronic glomerular sclerosis in a patient with wasp stings.

作者信息

Zhang Jian-Hui, Zou Jing, Ruan Dan-Dan, Chen Qian, Wu Min, Yu Hong-Ping, Wu Qiu-Yan, Lin Fan, Luo Jie-Wei, Zhang Li

机构信息

Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.

Department of Geriatric Medicine, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Fuzhou, China.

出版信息

Heliyon. 2024 Jul 9;10(14):e34353. doi: 10.1016/j.heliyon.2024.e34353. eCollection 2024 Jul 30.

Abstract

Wasp venom injections from wasp stings can damage several organs, most commonly the kidneys. Despite literature evidence, wasp sting-induced acute kidney injury (AKI) is rare and involves complex pathophysiological processes. While acute tubular necrosis (ATN) is the most prevalent histological result of wasp sting-induced AKI, uncommon combinations of chronic renal lesions have been described, alerting us to the patient's underlying illness. We report a 55-year-old hypertensive patient with unknown renal function who got AKI following multiple wasp stings. His renal function had not improved after continuous hemodialysis and plasma exchange; therefore, a kidney biopsy was performed. The pathology revealed that in addition to ATN, his kidney's distinguishing feature was a mix of chronic interstitial renal disease and chronic glomerulosclerosis. We think that his current renal pathological results were caused by hypertension in addition to wasp venom.

摘要

黄蜂蜇伤注入的毒液可损害多个器官,最常见的是肾脏。尽管有文献依据,但黄蜂蜇伤所致急性肾损伤(AKI)很罕见,且涉及复杂的病理生理过程。虽然急性肾小管坏死(ATN)是黄蜂蜇伤所致AKI最常见的组织学结果,但也有慢性肾损害的罕见组合被描述过,这提醒我们注意患者的基础疾病。我们报告一例55岁肾功能未知的高血压患者,在多次被黄蜂蜇伤后发生了AKI。持续血液透析和血浆置换后其肾功能未改善,因此进行了肾活检。病理显示,除ATN外,其肾脏的显著特征是慢性间质性肾病和慢性肾小球硬化症的混合。我们认为,除黄蜂毒液外,他目前的肾脏病理结果是由高血压引起的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d9/11301385/390d5b533c15/gr1.jpg

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Wasp sting-induced acute kidney injury.黄蜂蜇伤所致急性肾损伤。
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Acute tubulointerstitial nephritis after wasp stings.黄蜂蜇伤后急性肾小管间质性肾炎
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本文引用的文献

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Outcomes of wasp and bee stings in Taiwan.台湾黄蜂和蜜蜂蜇伤的结果。
Clin Toxicol (Phila). 2023 Mar;61(3):181-185. doi: 10.1080/15563650.2023.2173075. Epub 2023 Mar 9.
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Bioactive Peptides and Proteins from Wasp Venoms.蜂毒液中的生物活性肽和蛋白质。
Biomolecules. 2022 Mar 30;12(4):527. doi: 10.3390/biom12040527.
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Acute kidney injury.急性肾损伤。
Nat Rev Dis Primers. 2021 Jul 15;7(1):52. doi: 10.1038/s41572-021-00284-z.

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