Nephrotic syndrome after insect sting: a case report

ABSTRACT Minimal change disease accounts for up to 25% of the cases of nephrotic syndrome in adult population. The allergic mechanism has been associated with minimal change disease and allergens have been implied, namely insect stings. We present a case report of a woman with new onset of nephrotic syndrome after a non-hymenoptera insect sting, with biopsy-proven minimal change disease, that was accompanied by a pulmonary thromboembolism process. Complete remission with glucocorticoid therapy was observed, with sustained response for 6 months after discontinuation. A new exposure to insect sting in the same geographical region and season triggered a nephrotic syndrome relapse. Subsequent avoidance of the place resulted in a sustained remission for more than 4 years.【摘要】微小病变性肾病（Minimal change disease）在成人人群中占肾病综合征（nephrotic syndrome）病例的25%之多。现有研究将过敏机制与微小病变性肾病相关联，且已有证据提示过敏原与该病存在关联，其中以昆虫叮咬尤为典型。本文报告1例女性患者：该患者在遭受非膜翅目昆虫叮咬后新发肾病综合征，经活检证实为微小病变性肾病，同时并发肺血栓栓塞症（pulmonary thromboembolism）。患者接受糖皮质激素治疗后获得完全缓解，停药后疗效持续维持6个月。后续在同一地理区域及季节再次接触昆虫叮咬时，肾病综合征复发。患者后续规避该暴露场所后，病情持续缓解超过4年。