Kounis Syndrome and Multiorgan Failure Following Multiple Wasp Stings.

Wasp and bee stings are common in Sri Lanka, and systemic envenomation causes a spectrum of clinical manifestations that includes simple local allergic reaction to life-threatening multiple organ injury or failure. However, wasp toxin-induced acute myocardial infarction is very rare in the literature. Here, we describe a pregnant lady with mass wasp stings who developed toxin-induced acute myocardial infarction with multiorgan injury. The treating physician should anticipate the complications of massive envenomation following multiple wasp stings.

Shoulder pad and macroglossia: "two signs of AL amyloidosis".

"Shoulder pad" sign resulting from deposition of amyloid in the periarticular soft tissue is rare but it is pathognomonic for immunoglobulin amyloidosis (AL). Although the detection remains a challenge, it gives a strong clue leading to prompt diagnosis.

Immunoglobulin A Nephropathy with Erythrocytosis: An Unusual Association.

Immunoglobulin A (IgA) nephropathy is the commonest type of glomerular nephritis worldwide and is one of the leading causes of chronic kidney disease. Erythrocytosis is known to be associated with IgA nephropathy and other renal manifestations. We report a case of a 35-year-old male with grade 3 hypertensive retinopathy, erythrocytosis, and heavy proteinuria with an impaired renal function who was diagnosed as a case of erythrocytosis with IgA nephropathy and secondary focal segmental glomerulosclerosis. An extensive evaluation and prompt interventions significantly improved the outcome in this patient.