title: Clinicopathological course of acute kidney injury following brown recluse (Loxoscles reclusa) envenomation.
abstract: We report a case of severe systemic loxoscelism in a previously healthy young man. This was associated with a Coombs-positive hemolytic anemia, striking leukomid reaction, renal failure, respiratory failure and cardiovascular collapse. This is the first documented case of a renal biopsy in a patient with renal failure after envenomation by the brown recluse spider. Associated systemic toxicity usually resolves but requires prompt recognition and supportive care in an intensive care setting. We also discuss the potential mechanism by which the venom of this small spider can lead to multiorgan failure and possibly death.
authors.affiliation: Department of Medicine , Washington University School of Medicine , St Louis , MO , USA.
authors.forename: Siddiq
authors.initials: S
authors.lastname: Anwar
authors.affiliation: Department of Medicine , Washington University School of Medicine , St Louis , MO , USA ; Department of Pathology , Washington University School of Medicine , St Louis , MO , USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Torosyan
authors.affiliation: Department of Medicine , Washington University School of Medicine , St Louis , MO , USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Ginsberg
authors.affiliation: Department of Pathology , Washington University School of Medicine , St Louis , MO , USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Liapis
authors.affiliation: Department of Medicine , Washington University School of Medicine , St Louis , MO , USA.
authors.forename: Aubrey R
authors.initials: AR
authors.lastname: Morrison
keywords: Coombs-positive hemolytic anemia; acute kidney injury; brown recluse envenomation; loxoscelism; renal biopsy