TY - JOUR
T1 - Multiple hymenoptera stings in children
T2 - Clinical and laboratory manifestations
AU - Broides, Arnon
AU - Maimon, Michal S.
AU - Landau, Daniel
AU - Press, Joseph
AU - Lifshitz, Matitiahu
PY - 2010/10
Y1 - 2010/10
N2 - Multiple hymenoptera stings are a cause of rhabdomyolysis, elevated liver enzymes, clotting abnormalities, kidney injury, and even death. However, the progression of the clinical and laboratory findings has been described mainly in sporadic case reports. We report the clinical and laboratory manifestations of multiple hymenoptera stings in six children who were hospitalized and referred for a nephrology evaluation and follow-up over a 12-year period. One patient succumbed 13 h after the stinging accident. In the five surviving patients, we found somewhat similar pattern of clinical and laboratory course: rhabdomyolysis with elevated liver enzymes are the earliest manifestations, followed by kidney injury and anemia. An asymptomatic phase of several days between the stinging accident and severe kidney injury can occur. There was a strong seasonal association, with all six events occurring in August or September. In children with multiple hymenoptera stings, a somewhat predictable clinical and laboratory course is expected and an initial laboratory evaluation is needed, and even in asymptomatic children, a repeated laboratory evaluation is highly recommended.
AB - Multiple hymenoptera stings are a cause of rhabdomyolysis, elevated liver enzymes, clotting abnormalities, kidney injury, and even death. However, the progression of the clinical and laboratory findings has been described mainly in sporadic case reports. We report the clinical and laboratory manifestations of multiple hymenoptera stings in six children who were hospitalized and referred for a nephrology evaluation and follow-up over a 12-year period. One patient succumbed 13 h after the stinging accident. In the five surviving patients, we found somewhat similar pattern of clinical and laboratory course: rhabdomyolysis with elevated liver enzymes are the earliest manifestations, followed by kidney injury and anemia. An asymptomatic phase of several days between the stinging accident and severe kidney injury can occur. There was a strong seasonal association, with all six events occurring in August or September. In children with multiple hymenoptera stings, a somewhat predictable clinical and laboratory course is expected and an initial laboratory evaluation is needed, and even in asymptomatic children, a repeated laboratory evaluation is highly recommended.
KW - Children
KW - Hymenoptera
KW - Rhabdomyolysis
KW - Stings
UR - http://www.scopus.com/inward/record.url?scp=77956188523&partnerID=8YFLogxK
U2 - 10.1007/s00431-010-1209-4
DO - 10.1007/s00431-010-1209-4
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C2 - 20461529
AN - SCOPUS:77956188523
SN - 0340-6199
VL - 169
SP - 1227
EP - 1231
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
IS - 10
ER -