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Membranous nephropathy after multiple Hymenoptera stings: a case report

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Abstract

An association between Hymenoptera (bee and wasp) stings and nephrotic syndrome has been rarely reported. We report a case of nephrotic syndrome after multiple Hymenoptera stings, and membranous nephropathy was later diagnosed by a kidney biopsy. The patient was a 79-year-old woman who was stung by Hymenoptera at seven sites on her body. A weight gain of 3.7 kg was observed in the patient at 1 week after being stung, and she had considerable edema in both lower extremities. A urine protein concentration of 14.8 g/g creatinine and a serum albumin concentration of 1.7 g/dL led to the diagnosis of nephrotic syndrome. A percutaneous kidney biopsy 8 days after the Hymenoptera stings showed stage I membranous nephropathy. She was in complete remission 1 week after the administration of oral prednisolone 40 mg/day, which was started 14 days after Hymenoptera stings, and had no relapse of nephrotic syndrome. To the best of our knowledge, this is the first report of biopsy-proven membranous nephropathy caused by Hymenoptera stings.

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References

  1. Hoffman DR. Hymenoptera venom allergens. Clin Rev Allergy Immunol. 2006;30:109–28. https://doi.org/10.1385/CRIAI:30:2:109.

    Article  CAS  PubMed  Google Scholar 

  2. Vetter RS, Visscher PK, Camazine S. Mass envenomations by honey bees and wasps. West J Med. 1999;170:223–7 PMID: 10344177.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Rytand DA. Onset of the nephrotic syndrome during a reaction to bee sting. Stanford Med Bull. 1955;13:224–33 (PMID: 14386174).

    CAS  PubMed  Google Scholar 

  4. Venters HD, Vernier RL, Worthen HGGR. Bee sting nephrosis: a study of the immunopathologic mechanisms. Am J Dis Child. 1961;102:688–9.

    Google Scholar 

  5. Olivero JJ, Ayus JC, Eknoyan G. Nephrotic syndrome developing after bee stings. South Med J. 1981;74:82–3. https://doi.org/10.1097/00007611-198101000-00030.

    Article  CAS  PubMed  Google Scholar 

  6. Révai T, Harmos G. Simvastatin treatment in nephrotic syndrome associated with a bee sting. J R Soc Med. 1999;92:23–4. https://doi.org/10.1177/014107689909200110.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Zaman F, Saccaro S, Latif S, Atray N, Abreo K. Minimal change glomerulonephritis following a wasp sting. Am J Nephrol. 2001;21:486–9. https://doi.org/10.1159/000046653.

    Article  CAS  PubMed  Google Scholar 

  8. Humeda YS, Clapp WL, Humeda H. Minimal change disease after multiple wasp stings. Clin Nephrol Case–Stud. 2022;10:16–20. https://doi.org/10.5414/cncs110369.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Taber TE, King LH, Aust CH. Bee sting nephropathy in a transplant patient. Indiana Med. 1986;79:778–9 (PMID: 3534070).

    CAS  PubMed  Google Scholar 

  10. Sensirivatana R, Sukvichai P, Futrakul P. Nephrotic syndrome following a bee sting. J Med Assoc Thail. 1984;67:525–8 (PMID: 6520578).

    CAS  Google Scholar 

  11. Tauk B, Hachem H, Bastani B. Nephrotic syndrome with mesangial proliferative glomerulonephritis induced by multiple wasp stings. Am J Nephrol. 1999;19:70–2. https://doi.org/10.1159/000013429.

    Article  CAS  PubMed  Google Scholar 

  12. Bobart SA, Tehranian S, Sethi S, Alexander MP, Nasr SH, Moura Marta C, et al. A target antigen–based approach to the classification of membranous nephropathy. Mayo Clin Proc. 2021;96:577–91. https://doi.org/10.1016/j.mayocp.2020.11.028.

    Article  CAS  PubMed  Google Scholar 

  13. Ren S, Wu C, Zhang Y, Wang AY, Li G, Wang L, et al. An update on clinical significance of use of THSD7A in diagnosing idiopathic membranous nephropathy : a systematic review and meta- analysis of THSD7A in IMN. Ren Fail. 2018;40:306–13. https://doi.org/10.1080/0886022X.2018.1456457.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Sethi S, Debiec H, Madden B, Charlesworth MC, Morelle J, Gross LA, et al. Neural epidermal growth factor-like 1 protein (NELL-1) associated membranous nephropathy. Kidney Int. 2020;97:163–74. https://doi.org/10.1016/j.kint.2019.09.014.

    Article  CAS  PubMed  Google Scholar 

  15. Sethi S, Madden BJ, Debiec H, Cristine Charlesworth M, Gross L, Ravindran A, et al. Exostosin 1/exostosin 2–associated membranous nephropathy. J Am Soc Nephrol. 2019;30:1123–36. https://doi.org/10.1681/ASN.2018080852.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Sethi S, Debiec H, Madden B, Vivarelli M, Charlesworth MC, Ravindran A, et al. Semaphorin 3B–associated membranous nephropathy is a distinct type of disease predominantly present in pediatric patients. Kidney Int. 2020;98:1253–64. https://doi.org/10.1016/j.kint.2020.05.030.

    Article  CAS  PubMed  Google Scholar 

  17. Sethi S, Madden B, Debiec H, Morelle J, Charlesworth MC, Gross L, et al. Protocadherin 7–associated membranous nephropathy. J Am Soc Nephrol. 2021;32:1249–61. https://doi.org/10.1681/ASN.2020081165.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Caza TN, Hassen SI, Kuperman M, Sharma SG, Dvanajscak Z, Arthur J, et al. Neural cell adhesion molecule 1 is a novel autoantigen in membranous lupus nephritis. Kidney Int. 2021;100:171–81. https://doi.org/10.1016/j.kint.2020.09.016.

    Article  CAS  PubMed  Google Scholar 

  19. Bajcsi D, Bitó L, Turkevi-Nagy S, Nyári T, Kemény É, Légrády P, et al. The value of PLA2R antigen and IgG subclass staining relative to anti-PLA2R seropositivity in the differential diagnosis of membranous nephropathy. BMC Nephrol. 2023;24:230. https://doi.org/10.1186/s12882-023-03273-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Beck LH, Bonegio RGB, Lambeau G, Beck DM, Powell DW, Cummins TD, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009;361:11–21. https://doi.org/10.1056/NEJMoa0810457.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ishizaki J, Suzuki N, Higashino KI, Yokota Y, Ono T, Kawamoto K, et al. Cloning and characterization of novel mouse and human secretory phospholipase A2S. J Biol Chem. 1999;274:24973–9. https://doi.org/10.1074/jbc.274.35.24973.

    Article  CAS  PubMed  Google Scholar 

  22. Hossen MS, Shapla UM, Gan SH, Khalil MI. Impact of bee venom enzymes on diseases and immune responses. Molecules. 2017;22:1–16. https://doi.org/10.3390/molecules22010025.

    Article  CAS  Google Scholar 

  23. Ardalan MR, Ghafari A, Hamzavi F, Nasri H, Baradaran B, Majidi J, et al. Anti-phospholipase A2 receptor antibody in idiopathic membranous nephropathy: a report from Iranian population. J Nephropathol. 2013;2:241–8. https://doi.org/10.12860/JNP.2013.38.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Debiec H, Hanoy M, Francois A, Guerrot D, Ferlicot S, Johanet C, et al. Recurrent membranous nephropathy in an allograft caused by IgG3k targeting the PLA2 receptor. J Am Soc Nephrol. 2012;23:1949–54. https://doi.org/10.1681/ASN.2012060577.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Kudose S, Santoriello D, Debiec H, Canetta PA, Bomback AS, Stokes MB, et al. The clinicopathologic spectrum of segmental membranous glomerulopathy. Kidney Int. 2021;99:247–55. https://doi.org/10.1016/j.kint.2020.06.014.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Nephrology, Ichiyokai Harada Hospital, 7-10 Kairoyamacho, Saeki-ku, Hiroshima, Japan

    Kenichi Morii, Toshiki Doi, Yoshio Yuba, Aiko Okubo, Kazuomi Yamashita, Sonoo Mizuiri, Yoshiko Nishizawa & Kenichiro Shigemoto

  2. Department of Kidney Disease and Community Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan

    Kenichi Morii & Toshiki Doi

  3. Department of Analytic Human Pathology, Nippon Medical School, 1-25-16 Nezu, Bunkyo-ku, Tokyo, Japan

    Akira Shimizu

  4. Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan

    Takao Masaki

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  1. Kenichi Morii
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Correspondence to Toshiki Doi.

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Morii, K., Doi, T., Yuba, Y. et al. Membranous nephropathy after multiple Hymenoptera stings: a case report. CEN Case Rep (2023). https://doi.org/10.1007/s13730-023-00834-2

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