Clinical manifestation of multiple wasp stings with details of whole transcriptome analysis Two case reports

doi:10.1097/MD.0000000000024492

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23500

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23500

Title:	Clinical manifestation of multiple wasp stings with details of whole transcriptome analysis Two case reports
Authors:	Ou, WF;Huang, WH;Chiu, HF;Mao, YC;Wen, MC;Chen, CH;Hung, SJ;Wu, MJ;Wu, CL;Chao, WC
Keywords:	acute respiratory distress syndrome;case report;plasmapheresis;RNA-Seq;wasp
Date:	2021
Issue Date:	2022-08-05T09:38:18Z (UTC)
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
ISSN:	0025-7974
Abstract:	Introduction: Multiple wasp stings is an emergency result from systemic reactions to the toxin with a wide range of manifestations, and we presented 2 patients with distinct clinical and transcriptomic findings. Patient concerns: Two patients without systemic disease presented with nearly 90 painful papules after attacked by a swarm of wasps (Vespa basalis). Diagnosis: Patient 1 was a 44-year-old healthy male whose clinical manifestations mainly comprised hemolysis, hepatic injury, rhabdomyolysis, and acute kidney injury. Patient 2 was a 49-year-old healthy female who presented with severe acute respiratory distress syndrome (ARDS) in addition to certain clinical manifestations that were also found in patient 1. We used ribo- nucleic acid sequencing (RNA-Seq) to characterize the inflammatory responses of 2 patients with distinct clinical manifestations after multiple wasp stings. Interventions: Both 2 patients received 5 sessions of plasmapheresis, and patient-1 further received mechanical ventilation for 8 days as well as 8 sessions of hemodialysis until day 17. Outcomes: Both patients recovered uneventfully after the aforementioned management. We used RNA-Seq to demonstrate a largely regulated neutrophil-predominated immune response in patient 1. In patient 2, we found a profound neutrophilc response on week 1 and a robust neutrophilic as well as pro-inflammatory responses on week 2. Furthermore, we found increased expression of signals that were associated with renal system process on week 2. Conclusion: In conclusion, we report 2 patients who manifested with shared and distinct presentations after an attack by the same swarm of wasps. Both patients had hemolysis, rhabdomyolysis, hepatic injury and acute kidney injury, and 1 patient had ARDS. The whole transcriptomic analyses were consistent with the distinct clinical manifestation, and these results suggest the potential of RNA-Sequencing to disentangle complex inflammatory responses in patients with multiple wasp stings. Plasmapheresis and corticosteroid were administered to both patients and case 2 also underwent 8 sessions of hemodialysis.
URI:	http://dx.doi.org/10.1097/MD.0000000000024492 https://www.webofscience.com/wos/woscc/full-record/WOS:000612833500118 https://ir.csmu.edu.tw:8080/handle/310902500/23500
Relation:	MEDICINE ,2021,v100,issue 4
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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