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Nephrotic syndrome with mesangial proliferative glomerulonephritis induced by multiple wasp stings
1DePaul Medical Center, Saint Louis University Health Sciences Center, St. Louis, Mo., USA.
Abstract:
We report the case of a young male who developed severe nephrotic syndrome within 2-3 weeks after being stung by 3 wasps. A percutaneous kidney biopsy specimen revealed mesangioproliferative glomerulonephritis with occasional subepithelial deposits suggestive of early membranous nephropathy. The patient was treated with oral prednisone 60 mg/day with no significant clinical response after 4 weeks, at which point he was started on oral cyclophosphamide, 100 mg/day, while the prednisone dose was tapered to 20 mg every other day over a 2-week period. Six months after initiation of cyclophosphamide, he still has severe nephrotic syndrome. We also briefly review the literature on Hymenoptera sting associated nephrotic syndrome.
Insights
A young male developed severe nephrotic syndrome after wasp stings. Despite treatment with prednisone and cyclophosphamide, the condition persisted, highlighting a rare association between Hymenoptera stings and kidney disease.
Area of Science:
- Nephrology
- Immunology
- Toxicology
Background:
- Hymenoptera stings can trigger diverse immune responses.
- Nephrotic syndrome is a complex kidney disorder characterized by heavy proteinuria.
Observation:
- A young male presented with severe nephrotic syndrome 2-3 weeks post-wasp stings.
- Kidney biopsy showed mesangioproliferative glomerulonephritis with early membranous nephropathy features.
Findings:
- Standard treatment with prednisone and cyclophosphamide showed limited efficacy.
- The patient's severe nephrotic syndrome persisted for at least six months.
Implications:
- This case suggests a potential link between Hymenoptera stings and nephrotic syndrome.
- Further research is needed to understand the pathogenesis and optimal management of sting-induced nephropathies.