An interesting story of intravascular hemolysis but normal haptoglobin and bilirubin levels

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
Kriti Chauhan, N. Shandilya
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引用次数: 1

Abstract

Multiple bee stings are associated with intravascular hemolysis (IVH), rhabdomyolysis, hypotension, renal tubule injury, and all causing acute kidney injury. Evidence in support of hemolysis includes anemia, hyperbilirubinemia, hemoglobinemia, hemoglobinuria, low haptoglobin (Hp) levels, elevated lactate dehydrogenase, and Coomb's test (if antibody mediated). However, under certain circumstances, hemoglobinemia and hemoglobinuria may be the only evidence of IVH depending on the etiological factors in association with the environment inside the body. Bee venom is known to have deleterious actions on different tissue types (neurotoxin, muscle paralytic, hematotoxic, epithelial damage, etc.). Altogether, they determine the outcome and presentation. Apart from this, there are several conditions that determine the binding of oxygen and Hp to hemoglobin (Hb). Arterial blood gases (ABGs) play a very important role in this. Hence, it is important for the pathologists to have an understanding of ABG as well to know how even simple tests (Hb, bilirubin, and Hp) can get affected by them. We describe one such occurrence in a patient with multiple hornet bee stings and formulate the likely causes and pathogenesis.
一个有趣的故事,血管内溶血,但正常的血红蛋白和胆红素水平
多次蜜蜂蜇伤与血管内溶血(IVH)、横纹肌溶解、低血压、肾小管损伤有关,均可引起急性肾损伤。支持溶血的证据包括贫血、高胆红素血症、血红蛋白血症、血红蛋白尿、低接触珠蛋白(Hp)水平、乳酸脱氢酶升高和Coomb试验(如果抗体介导)。然而,在某些情况下,血红蛋白血症和血红蛋白尿可能是IVH的唯一证据,这取决于与体内环境相关的病因因素。已知蜂毒对不同类型的组织(神经毒素,肌肉麻痹,血液毒性,上皮损伤等)具有有害作用。总之,他们决定了结果和呈现。除此之外,还有几个条件决定氧和Hp与血红蛋白(Hb)的结合。动脉血气(ABGs)在其中起着非常重要的作用。因此,对于病理学家来说,了解ABG以及了解即使是简单的测试(Hb、胆红素和Hp)如何受到它们的影响是很重要的。我们描述一个这样的发生在一个病人与多个大黄蜂蜇伤和制定可能的原因和发病机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Clinical Sciences
Journal of Clinical Sciences MEDICINE, GENERAL & INTERNAL-
自引率
0.00%
发文量
15
审稿时长
45 weeks
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