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Myoglobin cast nephropathy following multiple bee stings.

Nishika Madireddy1, Meenakshi Swain1, Ravishankar Yalamarty2

  • 1Department of Pathology, Apollo Hospitals Jubilee Hills, Hyderabad, Telangana, India.

Indian Journal of Pathology & Microbiology
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Massive bee stings can cause severe kidney damage. This case highlights myoglobin cast nephropathy in a child, successfully treated with steroids and dialysis, leading to full renal recovery.

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Area of Science:

  • Toxicology
  • Nephrology
  • Pediatrics

Background:

  • Mass envenomation from bee stings can lead to severe systemic complications, including rhabdomyolysis and acute kidney injury.
  • Rhabdomyolysis-induced acute kidney injury is often attributed to myoglobin deposition in renal tubules.

Observation:

  • A 12-year-old female presented with anuria and hypertension after multiple bee stings.
  • Renal biopsy revealed tubular injury and intratubular pigmented casts positive for myoglobin.

Findings:

  • The patient was diagnosed with myoglobin cast nephropathy secondary to mass bee envenomation.
  • Treatment involved intravenous steroids and seven sessions of hemodialysis.

Implications:

  • This case underscores the potential for severe renal complications from mass bee stings in children.
  • Prompt diagnosis and management, including supportive care and immunosuppression, can lead to complete renal function recovery.