Acute renal failure after a sea anemone sting

A 27-year-old man suffering from severe swelling and pain in his right arm was referred to our hospital. He showed signs of acute renal failure (ARF) with severe dermatitis of his right arm. Three days before being admitted, he accidentally touched some kind of marine organism with his right hand wh ile snorkeling in the Sulu Sea around Cebu Island. Within a few minutes, he was experiencing severe pain in his right hand. Then his right hand gradua lly became swollen. The marine creature responsible for this injury was tho ught to have been a sea anemone, which is a type of coelenterate. Histologi c findings of a renal biopsy indicated that acute tubular necrosis (ATN) ha d caused ARF in this patient's case. Supportive therapies improved renal fu nction of this patient, and steroid pulse therapy attenuated the severe ski n discoloration. The ATN was thought to have been caused by the poison from a sea anemone because there were no other conceivable reasons for the pati ent's condition. This is the first time that a marine envenomation case has been reported in which the sting of a sea anemone has caused ATN without t he failure of any other organs. (C) 2000 by the National Kidney Foundation, Inc.