I have read with interest the recent report in the ARCHIVES by Díaz-Sánchez et al1 from Mexico about the survival of a 30-year-old man after massive (>2000) Africanized honeybee stings. The man experienced anaphylactic shock and multisystem (neurologic, hepatic, renal, and hematologic) organ failure due to the massive (not measured) bee envenomation. Forty-eight hours after the insect attack, an oliguric acute renal failure was treated by peritoneal dialysis (total number of sessions not reported) and, on the third day, plasmapheresis was initiated and repeated every other day for a total of 3 times. In my opinion, the surprising event was the fast resumption of renal function, with a serum creatinine level of 305 µmol/L (4.0 mg/dL) after 72 hours from the admission (84 hours after the insect attack), and the almost normal renal function (creatinine level, 130 µmol/L [1.7 mg/dL]) after 7 days.
Beccari M. Dialysis or Plasmapheresis for Acute Renal Failure Due to Africanized Honeybee Stings. Arch Intern Med. 1999;159(11):1254. doi: