title: Acute Interstitial Nephritis Following Multiple Asian Giant Hornet Stings.
abstract: BACKGROUND
  The Asian giant hornet is the largest wasp species in the world. Its stings can cause acute interstitial nephritis and acute renal failure. From July to October, 2013, Asian giant hornet attacks have killed 42 people and injured 1675 people with their powerful venomous stings in Hanzhong, Ankang, and Shangluo, three cities in the southern part of Shaanxi Province, China.
  
  
  METHODS
  We report here a case of a 42-year-old man with acute interstitial nephritis following multiple Asian giant hornet stings. On admission, the patient had difficulty breathing, headache, and numbness in both limbs (arm and leg). He was treated in the Emergency Department and Department of Nephrology with plasma exchange and dialysis within 24 hours after being stung. A kidney biopsy revealed acute interstitial nephritis with interstitial infiltrations of eosinophils and lymphocytes. After intensive treatment, his liver function recovered within 10 days. Along with oral methylprednisolone, his renal function recovered 1 month later.
  
  
  CONCLUSIONS
  This case shows that acute interstitial nephritis happens several days after being stung. Since the number of deaths in southern Shaanxi province is much higher than other places, our report draws the attention of fellow clinicians to the acute interstitial nephritis following multiple Asian giant hornet stings.
authors.affiliation: Department of Nephrology, 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong, Shaanxi, China (mainland).
authors.forename: Xiang-Dong
authors.initials: XD
authors.lastname: Li
authors.affiliation: Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China (mainland).
authors.forename: Zheng
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Nephrology, 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong, Shaanxi, China (mainland).
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhai
authors.affiliation: Department of Nephrology, 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong, Shaanxi, China (mainland).
authors.forename: Ming
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Nephrology, 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong, Shaanxi, China (mainland).
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Shen
authors.affiliation: Department of Nephrology, 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong, Shaanxi, China (mainland).
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Nephrology, 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong, Shaanxi, China (mainland).
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, 3201 Affiliated Hospital of Medical College of Xi'an Jiaotong University, Hanzhong, Shaanxi, China (mainland).
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000818:Animals; D001706:Biopsy; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications*; D008297:Male; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006435:Renal Dialysis; D014863:Wasps