Indian Journal of Pathology and Microbiology
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Year : 2023  |  Volume : 66  |  Issue : 1  |  Page : 177-179

Myoglobin cast nephropathy following multiple bee stings

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
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Source of Support: None, Conflict of Interest: None

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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