| CASE REPORT |
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| Year : 2023 | Volume
: 66
| Issue : 1 | Page : 177-179 |
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Myoglobin cast nephropathy following multiple bee stings
Nishika Madireddy1, Meenakshi Swain1, Ravishankar Yalamarty2
1 Department of Pathology, Apollo Hospitals Jubilee Hills, Hyderabad, Telangana, India
2 Ravi Chaitanya Kidney and Children's Hospital, Rajhamundry, Andhra Pradesh, India
Correspondence Address:
Meenakshi Swain
Senior Consultant, Department of Pathology, Apollo Hospitals Jubilee Hills, Road No. 72, Jubilee Hills, Hyderabad, Telangana – 500 033
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijpm.ijpm_981_21
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Bee stings usually result in mild allergic reactions; however, mass envenomation can cause severe complications such as rhabdomyolysis, hemolysis, shock, or multi-organ damage. Rhabdomyolysis can result in acute renal failure either by tubular obstruction by myoglobin casts or by direct cytotoxic injury. We present a case of a 12-year-old female child who presented with sudden onset anuria and hypertension following mass envenomation by bees. A renal biopsy was performed, the microscopic evaluation of which revealed tubular injury, with associated intratubular pigmented casts. The casts stained positive for myoglobin immunohistochemical stain, thus confirming a diagnosis of myoglobin cast nephropathy. The patient was given IV steroids and underwent seven sessions of hemodialysis, following which there was complete recovery of renal function.
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