Acute kidney injury complicating bee stings – a review

Authors

  • Geraldo Bezerra da Silva Junior Universidade de Fortaleza; Faculdade de Medicina; Centro de Ciências da Saúde
  • Adolfo Gomes Vasconcelos Junior Universidade de Fortaleza; Faculdade de Medicina; Centro de Ciências da Saúde
  • Amanda Maria Timbó Rocha Universidade de Fortaleza; Faculdade de Medicina; Centro de Ciências da Saúde
  • Vanessa Ribeiro de Vasconcelos Universidade de Fortaleza; Faculdade de Medicina; Centro de Ciências da Saúde
  • João de Barros Neto Universidade Federal do Amapá; Hospital de Clínicas Dr. Alberto Lima
  • Julye Sampaio Fujishima Universidade Federal do Amapá; Hospital de Clínicas Dr. Alberto Lima
  • Nathália Barros Ferreira Universidade Federal do Amapá; Hospital de Clínicas Dr. Alberto Lima
  • Elvino José Guardão Barros Universidade Federal do Rio Grande do Sul; Faculdade de Medicina; Hospital de Clínicas de Porto Alegre,
  • Elizabeth De Francesco Daher Universidade Federal do Ceará; Faculdade de Medicina; Departamento de Medicina Clínica

Keywords:

Bee stings, Hymenoptera, Complications, Acute kidney injury

Abstract

Bee stings can cause severe reactions and have caused many victims in the last years. Allergic reactions can be triggered by a single sting and the greater the number of stings, the worse the prognosis. The poisoning effects can be systemic and can eventually cause death. The poison components are melitin, apamin, peptide 401, phospholipase A2, hyaluronidase, histamine, dopamine, and norepinephrine, with melitin being the main lethal component. Acute kidney injury (AKI) can be observed in patients suffering from bee stings and this is due to multiple factors, such as intravascular hemolysis, rhabdomyolysis, hypotension and direct toxicity of the venom components to the renal tubules. Arterial hypotension plays an important role in this type of AKI, leading to ischemic renal lesion. The most commonly identified biopsy finding in these cases is acute tubular necrosis, which can occur due to both, ischemic injury and the nephrotoxicity of venom components. Hemolysis and rhabdomyolysis reported in many cases in the literature, were demonstrated by elevated serum levels of indirect bilirubin and creatine kinase. The severity of AKI seems to be associated with the number of stings, since creatinine levels were higher, in most cases, when there were more than 1,000 stings. The aim of this study is to present an updated review of AKI associated with bee stings, including the currently advised clinical approach.

Downloads

Download data is not yet available.

Downloads

Published

2017-01-01

Issue

Section

Review

How to Cite

Silva Junior, G. B. da, Vasconcelos Junior, A. G., Rocha, A. M. T., Vasconcelos, V. R. de, Barros Neto, J. de, Fujishima, J. S., Ferreira, N. B., Barros, E. J. G., & Daher, E. D. F. (2017). Acute kidney injury complicating bee stings – a review. Revista Do Instituto De Medicina Tropical De São Paulo, 59, e25. https://revistas.usp.br/rimtsp/article/view/133353