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논문분류	춘계학술대회 초록집
제목	Acute Tubulointerstitial Nephritis Leading to Acute Renal Failure Following Multiple Honeybee Stings
저자	Eun Ju Lee, Hyun Seop Cho, Hyun-Jung Kim, Se-Ho Chang, Dong Jun Park
출판정보	2014; 2014(1):
키워드	벌꿀, 급성신부전, 급성세뇨관 간질 신염
초록	Acute renal failure (ARF) by bee stings is rare complication. The main mechanism of ARF in bee sting includes acute cortical necrosis, secondary to intravascular hemolysis, rhabdomyolysis, direct toxic effect of the venom, and hypotension. However, acute tubulointerstitial nephritis (TIN) after bee sting is extremely rare. In this report we describe female who had multiple bee stings and developed acute renal failure as a result of TIN. A-74-year-old female was stung on lower limbs by multiple bees 3 days before and transferred to our emergency room due to azotemia aggravation. There were several sting markers on both limbs. Her initial serum creatinine was 4.2 mg/dL. At 3rd day after admission, hemodialysis was done because her urine output decreased to nearly zero, serum creatinine increased to 8.26 mg/dL, and she complained of nausea and vomiting. Total ten times of hemodialysis was done and her azotemia did not improve 3 weeks after admission, we undertook renal biopsy for the purpose of evaluation of etiology of ARF. Renal biopsy revealed normal glomerulus, but diffuse interstitial edema, patch infiltration of lymphocytes and neutrophils corresponding to TIN. Her renal function completely recovered with the medication of prednisolone for 2 months. From our extensive English literature review, this is the first report of ARF induced by AIN with bee sting although AIN by wasp sting was reported. Renal biopsy should be recommended, especially for a patient with delayed recovery of renal function after bee stings and early steroid use might help in renal recovery.
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