Haemolytic Uremic Syndrome a Hitherto Unreported Complication of Humpnosed Viper Envenomation

Abstract

Merrem's humpnosed viper bite is known to cause incoagulable blood, acute renal failure, acute respiratory distress syndrome, Raynaud's phenomenon and gangrene of the distal limb. Venom-induced consumptive coagulopathy (VICC) is the commonest coagulopathy that occurs following snake envenomation which is characterised by prolonged clotting times. In a small proportion of patients with VICC, microangiopathy is also seen. The authors report a novel case of haemolytic uraemic syndrome following a merrem's humpnosed viper bite, which highlights the need for comprehensive and serial haematological evaluation to detect the condition and initiate timely plasma exchange. The authors recommend screening of all victims of humpnosed viper bite for haemolytic uremic syndrome which might otherwise be overlooked and stress the need for further studies to see the role of haemolytic uremic syndrome following humpnosed viper bite.

Thrombotic microangiopathy due to Bothrops erythromelas: a case report in Northeast Brazil

“…The mechanistic pathway of acute kidney injury due to snakebite-associated thrombotic microangiopathy is fibrin microthrombi deposition, suggested by histological analyses reported in literature 7,[16][17][18] . Our patient developed rapidly and progressive AKI in the first 12 hours post-bite with increasing serum creatinine levels and decreasing estimated glomerular filtration rates.…”

Therapeutic plasma exchange for pediatric nonrenal disease indications and outcomes: A single-center experience

“…[34] There is no controlled trial showing the benefit of TPE in snake envenomation and evidence obtained so far is from case reports and case series. There are numerous reports of snake bite causing AKI and TMA from Sri Lanka[353637] and Australia,[383940] and successfully treated with hemodialysis and TPE as like in our two patients (Case no. 9 and 10).…”

Thrombotic Microangiopathy, Hemolytic Uremic Syndrome, and Thrombotic Thrombocytopenic Purpura Following Hump-nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka

“…Thus, this can also be considered as a type of atypical HUS or venom-induced HUS. It has previously been reported after hump-nosed pit viper, 29 Russell's viper, 30 and taipan envenomation. 31 Our patient in case 1 spontaneously recovered with symptomatic treatment even though she developed AKI associated with microangiopathic hemolysis and had a marginal drop in platelets.…”