title: Wasp envenomation-induced acute renal failure: a report of three cases.
abstract: Acute renal failure is an unusual complication of wasp stings. We report three cases who developed acute renal failure after multiple wasp stings (Vespa magnifica). Two patients had evidence of intravascular haemolysis and rhabdomyolysis whereas one patient investigation showed no evidence of intravascular haemolysis or rhabdomyolysis. All three cases had impaired liver functions. Oligo-anuria was seen in all three of the patients and all of them required dialytic support. One patient died of massive gastrointestinal bleeding while the remaining two recovered completely. Although acute renal failure after wasp stings is typically caused by acute tubular necrosis in the setting of haemolysis or rhabdomyolysis, in some patients, renal failure may result from a direct nephrotoxic effect or acute interstitial nephritis from a hypersensitivity reaction to the wasp venom.
authors.affiliation: Department of Nephrology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. sanjayvikrant@rediffmail.com
authors.forename: Sanjay
authors.initials: S
authors.lastname: Vikrant
authors.forename: Deveshwar
authors.initials: D
authors.lastname: Pandey
authors.forename: Prem
authors.initials: P
authors.lastname: Machhan
authors.forename: Dalip
authors.initials: D
authors.lastname: Gupta
authors.forename: Surinder Singh
authors.initials: SS
authors.lastname: Kaushal
authors.forename: Neelam
authors.initials: N
authors.lastname: Grover
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D000818:Animals; D002648:Child; D005260:Female; D006461:Hemolysis; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012206:Rhabdomyolysis / Q000209:etiology; D014863:Wasps