Allergy Asthma Respir Dis.  2018 Mar;6(2):128-130. 10.4168/aard.2018.6.2.128.

Rhabdomyolysis and diabetic ketoacidosis after bee sting: A case report

Affiliations
  • 1Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. sjk@knu.ac.kr

Abstract

Bee stings result in diverse clinical manifestations from localized pain, rash to life-threatening systemic allergic reactions or toxic reactions. Toxic reactions include skin necrosis, pancreatitis, acute renal failure, hemolysis or coagulopathy, while systemic allergic reactions present with IgE-mediated anaphylaxis. We experienced a 63-year-old woman who developed rhabdomyolysis and diabetic ketoacidosis after bee sting. The patient was accompanied by pulmonary edema due to acute kidney injury, which was recovered by intensive hemodialysis treatment. Here, we report a rare and serious case induced by bee sting with a review of the literature.

Keyword

Bee sting; Rhabdomyolysis; Diabetic ketoacidosis

MeSH Terms

Acute Kidney Injury
Anaphylaxis
Bees*
Bites and Stings*
Diabetic Ketoacidosis*
Exanthema
Female
Hemolysis
Humans
Hypersensitivity
Middle Aged
Necrosis
Pancreatitis
Pulmonary Edema
Renal Dialysis
Rhabdomyolysis*
Skin

Reference

1. Akdur O, Can S, Afacan G. Rhabdomyolysis secondary to bee sting. Case Rep Emerg Med. 2013; 2013:258421.
Article
2. Brown TC. Reactions to honeybee stings: an allergic prospective. Curr Opin Allergy Clin Immunol. 2013; 13:365–71.
3. Ito K, Imafuku S, Nakayama J. Rhabdomyolysis due to multiple wasp stings. Case Rep Dermatol Med. 2012; 2012:486724.
Article
4. Bridi RA, Balbi AL, Neves PM, Ponce D. Acute kidney injury after mas-sive attack of Africanised bees. BMJ Case Rep 2014 Mar 11. 2014. pii: bcr2013201381.
5. Dhanapriya J, Dineshkumar T, Sakthirajan R, Shankar P, Gopalakrishnan N, Balasubramaniyan T. Wasp sting-induced acute kidney injury. Clin Kidney J. 2016; 9:201–4.
Article
6. Kim YO, Yoon SA, Kim KJ, Lee BO, Kim BS, Chang YS, et al. Severe rhabdomyolysis and acute renal failure due to multiple wasp stings. Nephrol Dial Transplant. 2003; 18:1235.
Article
7. Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis: pathogenesis, diagnosis, and treatment. Ochsner J. 2015; 15:58–69.
8. Shorina EA, Mast NV, Lopina OD, Rubtsov AM. Melittin-induced inhibition and aggregation of Ca-ATPase in skeletal muscle sarcoplasmic re-ticulum: a comparative study. Biochemistry. 1997; 36:13455–60.
Article
9. Prado M, Solano-Trejos G, Lomonte B. Acute physiopathological effects of honeybee (Apis mellifera) envenoming by subcutaneous route in a mouse model. Toxicon. 2010; 56:1007–17.
Article
10. Gunasekera WT, Mudduwa L, Lekamwasam S. Acute pigmented tubu-lopathy and interstitial nephritis following wasp sting. Galle Med J. 2008; 13:55–6.
Article
11. Kamel KS, Schreiber M, Carlotti AP, Halperin ML. Approach to the treatment of diabetic ketoacidosis. Am J Kidney Dis. 2016; 68:967–72.
Article
12. Misra S, Oliver NS. Diabetic ketoacidosis in adults. BMJ. 2015; 351:h5660.
Article
13. Greenbaum G, Riley JD. Anaphylaxis-induced diabetic ketoacidosis. Am J Emerg Med. 1994; 12:331–3.
Article
Full Text Links
  • AARD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr