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題名 | Acute Renal Failure Complicated by Multiple Bee Stings: A Case Report and Literature Review=虎頭蜂叮咬併發急性腎衰竭--一個病例報告及文獻回顧 |
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作者 | 林信昌; 陳漢湘; 葉瑞圻; Lin, Hsin-chang; Chen, Han-hsiang; Yeh, Jui-chi; |
期刊 | 臺灣腎臟醫學會雜誌 |
出版日期 | 20010300 |
卷期 | 15:1 2001.03[民90.03] |
頁次 | 頁20-22+37 |
分類號 | 415.815 |
語文 | eng |
關鍵詞 | 蜂類叮咬; 急性腎衰竭; 血液透析; Acute renal failure; Bee stings; Hemodialysis; |
中文摘要 | 被蜂類叮咬並不是非常少見,人類被一群蜂類攻擊可能會導致嚴重併發症產生如急性腎衰竭、過敏性休克、散播性血管內血液凝結、肝功能異常及呼吸衰竭。而處理這此嚴重併發症需要迅速積極的治療。我們報導一位男性病人在被一大群虎頭蜂叮咬後,病人的頭、臉、四肢有一百多處叮咬傷口,呈現紅腫熱痛,並且產生過敏性休克,急性腎衰竭合併排尿量減少及肝功能異常發生。病人並沒有發生血管內溶血及橫紋肌溶解症。我們推測病人發生急性腎衰的原因可能跟休克導致腎血流灌注量不足或蜂毒的腎毒性有關。經過一連患的治療包括十餘次血產透析治療後,病人的臨床症狀逐漸改善而且後來肝臟及腎臟功能完全恢復正常。 |
英文摘要 | Attacks by bees are not rare. Multiple bee stings may be associated with severe complications including cardiovascular insufficiency (shock, myocardial damage), respiratory failure (adult respiratory distress syndrome, bronchospasm), disseminated intravascular coagulation (DIC), renal and hepatobiliary disorders. 1-6 We describe a patient who developed anaphylactic shock followed by acute renal failure and hepatic dysfunction after numerous bees attack. More than one hundred sting wounds were found over his face, head and extremities. No evidence of hemolysis with hemoglobulinuria or rhabdomyolysis with myoglobulinuria was detected. Initial anaphylactic shock or direct nephrotoxicity of bee venom was presumed to be the pathophysiologic mechanism of acute renal failure. He was treated with a series of managements including hemodialysis. Fortunately, he recovered completely and was without renal and hepatic sequelae two months after the bee attack. |
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