Acute Kidney Injury Secondary to Lonomia envenomation. Case Report and Literature Review

Abstract

Introduction The envenomation by Lonomia species mainly occur in rural areas. The main symptom of this condition is an alteration in the clotting times and hemorrhage. However, acute kidney injury is been also identified in some case reports. Therefore, it should not be disregarded and to understand the pathophysiological mechanism, diagnosis and treatment of this clinical feature results necessary in order to expand awareness and to prevent further medical complications and death. Materials and Methods We present a case report and scoping review of the literature to characterize patients with acute kidney injury secondary to Lonomia envenomation by a case report and describing the pathophysiology, diagnosis, treatment and prognosis of patients suffering from this condition. The information was obtained from 4 databases: Medline, Embase, LILACs and Ovid. We used the following search strategy: (((“Acute Kidney Injury” [Mesh]) AND “lonofibrase” [Supplementary Concept]) OR lonomy accident) OR lonomia. Results We identified ten case reports of Lonomia spp. Envenomation, nine of them were caused by L. obliqua and one by L. achelous. A cohort study that included 37 patients who were exposed to the L. obliqua venom was also included. All patients were adults, lived in the countryside and developed acute kidney injury. Conclusions Acute kidney injury has been identified as one important clinical feature of the Lonomia envenomation. The development of this condition is mediated by various pathophysiological mechanisms. To perform an adequate diagnosis, coagulation times, fibrinogen levels, hemogram, kidney function and urinalysis should be done. The definitive treatment depends on the type of envenomation. The prognosis for these patients is not well described yet. However, our patient had a good response to the described management given.