European Journal of Pediatrics

, Volume 169, Issue 10, pp 1227–1231

Multiple hymenoptera stings in children: clinical and laboratory manifestations

  • Arnon Broides
  • Michal S. Maimon
  • Daniel Landau
  • Joseph Press
  • Matitiahu Lifshitz
Original Paper

DOI: 10.1007/s00431-010-1209-4

Cite this article as:
Broides, A., Maimon, M.S., Landau, D. et al. Eur J Pediatr (2010) 169: 1227. doi:10.1007/s00431-010-1209-4

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.

Keywords

Hymenoptera Stings Children Rhabdomyolysis 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Arnon Broides
    • 1
    • 4
  • Michal S. Maimon
    • 1
  • Daniel Landau
    • 2
  • Joseph Press
    • 1
  • Matitiahu Lifshitz
    • 3
  1. 1.Pediatric Emergency Department, Soroka University Medical Center and the Faculty of Health SciencesBen-Gurion UniversityBeer-ShevaIsrael
  2. 2.Pediatric Nephrology Unit, Soroka University Medical Center and the Faculty of Health SciencesBen-Gurion UniversityBeer-ShevaIsrael
  3. 3.Clinical Toxicology Unit, Soroka University Medical Center and the Faculty of Health SciencesBen-Gurion UniversityBeer-ShevaIsrael
  4. 4.Pediatric Emergency DepartmentSoroka University Medical CenterBeer-ShevaIsrael

Personalised recommendations