Acute interstitial nephritis and pigmented tubulopathy in a patient after wasp stings.
Acute renal failure (ARF) is an unusual complication of wasp stings and mostly results from toxic-ischemic acute tubular necrosis. This patient, who was stung by a swarm of wasps, experienced an allergic reaction, rhabdomyolysis, intravascular hemolysis, and subsequent ARF. The originality of this case report is related to the finding of combined lesions of acute tubulointerstitial nephritis and acute tubular nephropathy. From our extensive literature review, it is the first case of a patient developing this type of injury after wasp stings, and the complications have been documented previously only in one form or another. Renal biopsy should be encouraged, especially for a patient with delayed recovery of renal function after wasp stings, to facilitate early steroid treatment for the patient with the histological change of acute interstitial nephritis. Early use of steroid therapy may hasten renal recovery by preventing the development of interstitial fibrosis.
Chao
Yu-Wen
YW
Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan.
Yang
An-Hang
AH
Ng
Yee-Yung
YY
Yang
Wu-Chang
WC
D058186:Acute Kidney Injury / Q000209:etiology; D000818:Animals; D006461:Hemolysis; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007299:Insect Bites and Stings / Q000150:complications*; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000209:etiology* / Q000473:pathology; D012206:Rhabdomyolysis / Q000209:etiology; D014863:Wasps