Severe Acute Kidney Injury in a Child after Accidental Contact with Lonomia obliqua: Case Report

The article reports a case of acute kidney injury (AKI) in a child after contact with the caterpillar Lonomia obliqua (LO) whose venom acts on the inflammatory and coagulation system causing hemorrhagic syndrome similar to disseminated intravascular coagulation (DICC), hemolytic anemia and also AKI. As pathophysiological mechanisms we have: deposition of microthrombi in the glomeruli, ischemic effect by hemorrhagic shock associated with hypotension and direct action of the venom. At hospital admission, the patient presented gingivorrhagia, myalgia, abdominal pain, jaundice and oliguria. She was referred to the ICU receiving support measures and 4 ampoules of antilonomic serum (SAlon), with improvement of coagulation disorders, but worsening of AKI with indication for renal replacement therapy. After 12 days of hospitalization, she was discharged from hospital with normal renal function.