Hymenoptera Stings and the Acute Kidney Injury

Yashad Dongol,1 Rakesh Kumar Shrestha,2 Gopi Aryal,3 Dhananjaya Bhadrapura Lakkappa4

1. Department of Biochemistry, KIST Medical College, Lalitpur, Kathmandu, Nepal
2. Department of Pharmacy and Biochemistry, JF Institute of Health Sciences/LA College of Higher Studies, Lalitpur, Kathmandu, Nepal
3. Department of Pathology, KIST Medical College, Lalitpur, Kathmandu, Nepal
4. Department of Research, School of Chemical and Biotechnology, SASTRA University, Thirumalaisamudram, Thanjavur, Tamil Nadu, India

Disclosure: No potential conflict of interest.
Citation: EMJ Neph. 2013;1:68-75.

Abstract

Hymenoptera stings are a health concern. Apidae (bees), Vespidae (hornets, yellow jackets and wasps) and Formicidae (ants) are medically-important stinging insects under the order Hymenoptera. Clinical features from simple skin manifestations to severe and fatal organ injury are due to the hypersensitivity reactions and/ or the toxic effects of the venom inoculated. Here we discuss on Hymenoptera stings involving apids (honey bees) and vespids (wasps, hornets and yellow jackets) and their effect on renal function and associated morphological changes in the kidney. Despite the differences in venom composition and quantity released per sting in two insect groups, both lead to similar medical consequences, such as localised normal allergic reactions, mild to severe anaphylaxis and shock and multiple organ and tissue injury leading to multiple organ failure. Acute kidney injury (AKI) is one of the unusual complications of Hymenoptera stings and has the basis of both immune-mediated and toxic effects. Evidence has proven that supportive therapy along with the standard medication is very efficient in completely restoring the kidney function without any recurrence.

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