Kidney injury following envenoming by hump-nosed pit viper (Genus:<i>Hypnale</i>) in Sri Lanka: proven and probable cases

Rathnayaka, R.M.M.K. Namal; Ranathunga, P.E. Anusha Nishanthi; Kularatne, S.A.M.

doi:10.1093/trstmh/try120

Cited by 24 publications

(47 citation statements)

References 34 publications

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“…russelii envenoming [ 6 ]. Owing to the fact that envenomings by these species have common initial clinical manifestations [ 21 , 42 , 50 , 52 ], identification of the snake responsible is a challenge in clinical practice. Currently administration of Indian polyvalent antivenom is indicated for envenomings by D .…”

Section: Discussionmentioning

confidence: 99%

“…Guidelines for the management of snakebite envenoming do not recommend capturing the offending snake and bringing it to the hospital, owing to the risks of bites [48]. Lack of venom confirmation has limited the identification of snakebite cases in many clinical studies [49,50]. Use of venom EIA would facilitate enrolling all envenomed patients in future clinical studies, hence strengthening the association between snake identification and clinical and therapeutic findings.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

“…In Sri Lanka, the majority of snakebites are caused by H. hypnale, and most severe cases and fatalities are due to D. russelii envenoming [6]. Owing to the fact that envenomings by these species have common initial clinical manifestations [21,42,50,52], identification of the snake responsible is a challenge in clinical practice. Currently administration of Indian polyvalent antivenom is indicated for envenomings by D. russelii, but not for those inflicted by Hypnale sp [48].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

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Enzyme immunoassays for detection and quantification of venoms of Sri Lankan snakes: Application in the clinical setting

et al. 2020

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Background Detection and quantification of snake venom in envenomed patients' blood is important for identifying the species responsible for the bite, determining administration of antivenom, confirming whether sufficient antivenom has been given, detecting recurrence of envenoming, and in forensic investigation. Currently, snake venom detection is not available in clinical practice in Sri Lanka. This study describes the development of enzyme immunoassays (EIA) to differentiate and quantify venoms of Russell's viper (Daboia russelii), saw-scaled viper (Echis carinatus), common cobra (Naja naja), Indian krait (Bungarus caeruleus), and hump-nosed pit viper (Hypnale hypnale) in the blood of envenomed patients in Sri Lanka. Methodology / Principal findings A double sandwich EIA of high analytical sensitivity was developed using biotin-streptavidin amplification for detection of venom antigens. Detection and quantification of D. russelii, N. naja, B. caeruleus, and H. hypnale venoms in samples from envenomed patients was achieved with the assay. Minimum (less than 5%) cross reactivity was observed between species, except in the case of closely related species of the same genus (i.e., Hypnale). Persistence/ recurrence of venom detection following D. russelii envenoming is also reported, as well as detection of venom in samples collected after antivenom administration. The lack of specific antivenom for Hypnale sp envenoming allowed the detection of venom antigen in circulation up to 24 hours post bite. Conclusion The EIA developed provides a highly sensitive assay to detect and quantify five types of Sri Lankan snake venoms, and should be useful for toxinological research, clinical studies, and forensic diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

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Enzyme immunoassays for detection and quantification of venoms of Sri Lankan snakes: Application in the clinical setting

et al. 2020

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“…7 The key clinical features in this favouring HNV bite are local envenoming, non-coagulable blood and renal failure. 3,4,8 Fang marks are invariably found after HNV bite. Typical local envenomation, skin and soft tissue swelling, necrosis and systemic envenomation are suggestive of HNV bite in our patient.…”

Section: Discussionmentioning

confidence: 99%

“…1 In a prospective study of snakebites involving 10 hospitals in Sri Lanka, 302 (35%) of 860 patients with bites by identified snakes proved to have been bitten by hump-nosed pit vipers. 2 It has now been established that HNVs are highly venomous and the clinical presentation ranges from local swelling and necrosis at the bite site with distinct fang marks to systemic envenomation leading to coagulopathy, thrombotic microangiopathy (TMA), acute kidney injury and death in severe cases [3][4][5] Here, we present a case of delayed presentation to medical care with HNV 'Hypnale' bite.…”

Section: Introductionmentioning

confidence: 99%

Thrombotic microangiopathy following hump-nosed viper ‘Hypnale’ envenomation

Puthra

Pirasath

Sugathapala

et al. 2020

SAGE Open Medical Case Reports

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The hump-nosed vipers which compromise ‘ Hypnale hypnale’, ‘H. zara’ and ‘H. nepa’ have been highly venomous snakes and ‘H. zara’ and ‘H. nepa’ are indigenous to Sri Lanka and ‘H. hypnale’ is endemic to Sri Lanka and India. The clinical presentations range from local swelling, blistering and necrosis at the site of bite with distinct fang marks to systemic envenomations such as coagulopathy, thrombotic microangiopathy, acute kidney injury and death in severe cases. Here, we report a case of thrombotic microangiopathy following hump-nosed viper ‘ Hypnale’ bite.

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Nephrotoxicity induced by the venom of Hypnale hypnale from Sri Lanka: Studies on isolated perfused rat kidney and renal tubular cell lines

Villalta

Sampaio

Menezes

et al. 2019

Toxicon

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Kidney injury following envenoming by hump-nosed pit viper (Genus:Hypnale) in Sri Lanka: proven and probable cases

Cited by 24 publications

References 34 publications

Enzyme immunoassays for detection and quantification of venoms of Sri Lankan snakes: Application in the clinical setting

Enzyme immunoassays for detection and quantification of venoms of Sri Lankan snakes: Application in the clinical setting

Thrombotic microangiopathy following hump-nosed viper ‘Hypnale’ envenomation

Nephrotoxicity induced by the venom of Hypnale hypnale from Sri Lanka: Studies on isolated perfused rat kidney and renal tubular cell lines

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