Multiple hymenoptera stings in children: Clinical and laboratory manifestations

Arnon Broides, Michal S. Maimon, Daniel Landau, Joseph Press, Matitiahu Lifshitz

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7 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1227-1231
Number of pages5
JournalEuropean Journal of Pediatrics
Volume169
Issue number10
DOIs
StatePublished - 1 Oct 2010

Keywords

  • Children
  • Hymenoptera
  • Rhabdomyolysis
  • Stings

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