Membranous nephropathy after multiple Hymenoptera stings: a case report.

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 3.7kg was observed in the patient at 1week after being stung, and she had considerable edema in both lower extremities. A urine protein concentration of 14.8g/g creatinine and a serum albumin concentration of 1.7g/dL led to the diagnosis of nephrotic syndrome. A percutaneous kidney biopsy 8days after the Hymenoptera stings showed stage I membranous nephropathy. She was in complete remission 1week after the administration of oral prednisolone 40mg/day, which was started 14days 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.