벌독 아나필락시스쇼크 후 병발한 신부전과스트레스성 심근병증 1예
AKI and Takotsubo Cardiomyopathy after Bee Venom-induced Anaphylaxis
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초록
벌독에 의한 아나필락시스는 노출 후 수분에서 수시간 내에 일어나는 전신적인 알레르기 반응이며, 주로 제1형 즉시형 과민 반응을 통해 일어난다[1]. 단순 두드러기와 피하혈관부종, 기관지 경련(bronchospasm), 기도부종(large airway edema), 저혈압(hypotension), 오심, 구토 등의 반응이 나타난다. 이외에 상대적으로 낮은 빈도로 급성 관상동맥증후군, 심방세동, 심방조동, 심실세동, 스트레스성 심근병증이 나타나고, 드물기는 하지만 혈관내 용혈, 횡문근융해증 등에 의한 급성 신부전 등이 발생할 수 있다[1,2].
Abstract
Bee venom-induced anaphylaxis usually causes urticaria, angioedema, respiratory distress, nausea, and vomiting. Occasionally, it leads to unusual complications such as acute myocardial infarction, takotsubo cardiomyopathy, arrhythmia, rhabdomyolysis, intravascular hemolysis, and acute kidney injury. Renal complications are rare, and there are only two cases of acute kidney injury associated with rhabdomyolysis due to multiple bee stings reported in Korea. We report a 67-year-old woman who presented at our emergency department with confusion, respiratory distress, and dizziness after multiple bee stings. She was diagnosed with anaphylactic shock. There was acute kidney injury associated with rhabdomyolysis and heart failure related to takotsubo cardiomyopathy, all of which indicated unusual and fatal complications. Her condition worsened, almost requiring intubation and mechanical ventilation. However, the patient recovered without cardiac or renal complications within 30 days of therapy with hydration and diuretics.
참고문헌 (10)
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