Acute renal failure provoked by toxin from caterpillars of the species Lonomia obliqua

Acute renal failure (ARF) is a complication of envenoming by contact with caterpillars of the species Lonomia obliqua. A cohort study was conducted to evaluate development of acute and chronic renal failure (CRF) in patients who been in contact with L. obliqua during the period from 1989 to 2003 in the State of Santa Catarina, southern Brazil. Patients were evaluated in two distinct groups: those prior to 1995, who did not receive specific treatment of any type, and those after this date who were treated with antilonomic serum (SALon). The presence of creatinine ≥1.5 mg/dl in patients who had no history of previous renal illness was considered to be indicative of acute kidney failure. Of the 2067 patients evaluated, 39 (1.9%) developed ARF. Eleven (32%) of these patients were treated with dialysis and four (10.3%) developed CRF. The seven deaths (4%) occurred in the period before treatment with SALon. Blood coagulation measures (TC, TP, and TTPA), were significantly longer in the group with ARF. All patients with ARF and 67% of the control group presented hematuria. The majority of the patients recovered prior renal function, however, four (10.3%) needed chronic dialysis. Envenoming by L. obliqua can be considered an important risk factor for the development of potentially fatal ARF, as well as for developing CRF.