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Acute kidney injury complicating bee stings - a review.

Abstract Bee stings can cause severe reactions and have caused many victims in the last years. Allergic reactions can be triggered by a single sting and the greater the number of stings, the worse the prognosis. The poisoning effects can be systemic and can eventually cause death. The poison components are melitin, apamin, peptide 401, phospholipase A2, hyaluronidase, histamine, dopamine, and norepinephrine, with melitin being the main lethal component. Acute kidney injury (AKI) can be observed in patients suffering from bee stings and this is due to multiple factors, such as intravascular hemolysis, rhabdomyolysis, hypotension and direct toxicity of the venom components to the renal tubules. Arterial hypotension plays an important role in this type of AKI, leading to ischemic renal lesion. The most commonly identified biopsy finding in these cases is acute tubular necrosis, which can occur due to both, ischemic injury and the nephrotoxicity of venom components. Hemolysis and rhabdomyolysis reported in many cases in the literature, were demonstrated by elevated serum levels of indirect bilirubin and creatine kinase. The severity of AKI seems to be associated with the number of stings, since creatinine levels were higher, in most cases, when there were more than 1,000 stings. The aim of this study is to present an updated review of AKI associated with bee stings, including the currently advised clinical approach.
PMID
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Authors

Mayor MeshTerms

Bees

Keywords
Journal Title revista do instituto de medicina tropical de sao paulo
Publication Year Start


 


PMID- 28591253
OWN - NLM
STAT- MEDLINE
DA  - 20170607
DCOM- 20170705
LR  - 20170705
IS  - 1678-9946 (Electronic)
IS  - 0036-4665 (Linking)
VI  - 59
DP  - 2017 Jun 01
TI  - Acute kidney injury complicating bee stings - a review.
PG  - e25
LID - S0036-46652017005000301 [pii]
LID - 10.1590/S1678-9946201759025 [doi]
AB  - Bee stings can cause severe reactions and have caused many victims in the last
      years. Allergic reactions can be triggered by a single sting and the greater the 
      number of stings, the worse the prognosis. The poisoning effects can be systemic 
      and can eventually cause death. The poison components are melitin, apamin,
      peptide 401, phospholipase A2, hyaluronidase, histamine, dopamine, and
      norepinephrine, with melitin being the main lethal component. Acute kidney injury
      (AKI) can be observed in patients suffering from bee stings and this is due to
      multiple factors, such as intravascular hemolysis, rhabdomyolysis, hypotension
      and direct toxicity of the venom components to the renal tubules. Arterial
      hypotension plays an important role in this type of AKI, leading to ischemic
      renal lesion. The most commonly identified biopsy finding in these cases is acute
      tubular necrosis, which can occur due to both, ischemic injury and the
      nephrotoxicity of venom components. Hemolysis and rhabdomyolysis reported in many
      cases in the literature, were demonstrated by elevated serum levels of indirect
      bilirubin and creatine kinase. The severity of AKI seems to be associated with
      the number of stings, since creatinine levels were higher, in most cases, when
      there were more than 1,000 stings. The aim of this study is to present an updated
      review of AKI associated with bee stings, including the currently advised
      clinical approach.
FAU - Silva, Geraldo Bezerra da Junior
AU  - Silva GBD Junior
AD  - Universidade de Fortaleza, Faculdade de Medicina, Centro de Ciencias da Saude,
      Fortaleza, Ceara, Brazil.
FAU - Vasconcelos, Adolfo Gomes Junior
AU  - Vasconcelos AG Junior
AD  - Universidade de Fortaleza, Faculdade de Medicina, Centro de Ciencias da Saude,
      Fortaleza, Ceara, Brazil.
FAU - Rocha, Amanda Maria Timbo
AU  - Rocha AMT
AD  - Universidade de Fortaleza, Faculdade de Medicina, Centro de Ciencias da Saude,
      Fortaleza, Ceara, Brazil.
FAU - Vasconcelos, Vanessa Ribeiro de
AU  - Vasconcelos VR
AD  - Universidade de Fortaleza, Faculdade de Medicina, Centro de Ciencias da Saude,
      Fortaleza, Ceara, Brazil.
FAU - Barros, Joao de Neto
AU  - Barros J Neto
AD  - Universidade Federal do Amapa, Hospital de Clinicas Dr. Alberto Lima, Macapa,
      Amapa, Brazil.
FAU - Fujishima, Julye Sampaio
AU  - Fujishima JS
AD  - Universidade Federal do Amapa, Hospital de Clinicas Dr. Alberto Lima, Macapa,
      Amapa, Brazil.
FAU - Ferreira, Nathalia Barros
AU  - Ferreira NB
AD  - Universidade Federal do Amapa, Hospital de Clinicas Dr. Alberto Lima, Macapa,
      Amapa, Brazil.
FAU - Barros, Elvino Jose Guardao
AU  - Barros EJG
AD  - Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Hospital de
      Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
FAU - Daher, Elizabeth De Francesco
AU  - Daher EF
AD  - Universidade Federal do Ceara, Faculdade de Medicina, Departamento de Medicina
      Clinica, Fortaleza, Ceara, Brazil.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170601
PL  - Brazil
TA  - Rev Inst Med Trop Sao Paulo
JT  - Revista do Instituto de Medicina Tropical de Sao Paulo
JID - 7507484
RN  - 0 (Bee Venoms)
SB  - IM
MH  - Acute Kidney Injury/*etiology/physiopathology/therapy
MH  - Animals
MH  - Bee Venoms/chemistry/*poisoning
MH  - *Bees
MH  - Humans
MH  - Insect Bites and Stings/*complications
PMC - PMC5459532
EDAT- 2017/06/08 06:00
MHDA- 2017/07/06 06:00
CRDT- 2017/06/08 06:00
PHST- 2017/01/31 [received]
PHST- 2017/03/31 [accepted]
AID - S0036-46652017005000301 [pii]
AID - 10.1590/S1678-9946201759025 [doi]
PST - epublish
SO  - Rev Inst Med Trop Sao Paulo. 2017 Jun 1;59:e25. doi: 10.1590/S1678-9946201759025.