Plasmapheresis in a case of acute kidney injury with severe hemolysis and thrombocytopenia due to hematotoxic (Russell's viper) snake bite

Arora, Puneet; Belwal, Shantanu; Uniyal, Bhupesh; Saxena, SK

doi:10.4103/1319-2442.279953

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…While heparin has not been shown to improve VICC outcomes, fresh frozen plasma should be considered for bleeding patients to expedite the recovery of coagulopathy. In cases of TMA manifestations, the American Society of Apheresis considers plasmapheresis a weak recommendation that must be individualised for each clinical case [ 116 ]. To date, there are no reports of TMA treated with plasmapheresis in patients bitten by European vipers.…”

Section: Results—clinical Management Of Vipera Env...mentioning

confidence: 99%

A Guide to the Clinical Management of Vipera Snakebite in Italy

Di Nicola,

Crevani,

Avella

et al. 2024

Toxins

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The genus Vipera encompasses most species of medically significant venomous snakes of Europe, with Italy harbouring four of them. Envenomation by European vipers can result in severe consequences, but underreporting and the absence of standardised clinical protocols hinder effective snakebite management. This study provides an updated, detailed set of guidelines for the management and treatment of Vipera snakebite tailored for Italian clinicians. It includes taxonomic keys for snake identification, insights into viper venom composition, and recommendations for clinical management. Emphasis is placed on quick and reliable identification of medically relevant snake species, along with appropriate first aid measures. Criteria for antivenom administration are outlined, as well as indications on managing potential side effects. While the protocol is specific to Italy, its methodology can potentially be adapted for other European countries, depending on local resources. The promotion of comprehensive data collection and collaboration among Poison Control Centres is advocated to optimise envenomation management protocols and improve the reporting of epidemiological data concerning snakebite at the country level.

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Section: Results—clinical Management Of Vipera Env...mentioning

confidence: 99%

A Guide to the Clinical Management of Vipera Snakebite in Italy

Di Nicola,

Crevani,

Avella

et al. 2024

Toxins

View full text Add to dashboard Cite

show abstract

“…One additional plasmapheresis session was planned 24 h later, but the patient and family refused due to financial constraints. However, the patient’s hemoglobin and platelet count had stopped falling and all markers of hemolysis were within normal limits [ 12 ]. There is very limited evidence on the use of plasmapheresis for L. reclusa envenomation.…”

Section: Discussionmentioning

confidence: 99%

Acute Hemolytic Anemia Caused by Loxoscelism Treated With Plasmapheresis: A Case Report

Harry¹,

Brugioni²,

Madhusudhana³

2022

J Med Cases

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The bite of a brown recluse spider ( Loxosceles reclusa ) is usually associated with skin necrosis; however, it can lead to more significant morbidity including acute hemolytic anemia, rhabdomyolysis, disseminated intravascular coagulopathy and death. Here we highlight a case using plasmapheresis as treatment for acute hemolytic anemia caused by the bite of a brown recluse spider. A 49-year-old male presented to the emergency room 5 days after suffering a spider bite due to worsening symptoms. He had worsening pain at the site of the bite, diffuse body myalgias, darkening of his urine, chills, and shortness of breath. Hematology was consulted to assist in the management of hemolytic anemia refractory to multiple blood transfusions, worsening acute kidney failure requiring hemodialysis, and concern for impending death. After a literature review suggesting plasmapheresis may be beneficial in this scenario, the case was discussed with the local blood bank, and plasmapheresis was initiated. The patient underwent plasmapheresis with albumin for 2 days and the patient’s hemoglobin improved and stabilized. Therapy of loxoscelism is directed at limiting the dermatonecrosis at the site of the envenomation and in cases of systemic illness supportive care is recommended. Therapeutic plasma exchange has been shown efficacious in treating snake envenomation, but there are limited data detailing its use for brown recluse spider envenomation. Here we present a case to highlight the benefit of plasmapheresis in a patient with acute hemolytic anemia secondary to a brown recluse spider bite.

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Acute thrombocytopenia induced by trastuzumab due to complement reaction: A case report

Chen

et al. 2022

Front. Med.

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BackgroundThe usual treatment option for HER2 breast cancer is targeted therapy with trastuzumab. The common adverse effects of trastuzumab treatment are thrombocytopenia, however, acute thrombocytopenia is rare and its mechanism is still largely unknown.Case presentationWe reported a patient who presented with acute thrombocytopenia on two consecutive occasions, and the predisposing factor was identified on the second occasion because of trastuzumab-only treatment. Routine blood results showed a dramatic increase in white blood cell count and neutrophil count after both trastuzumab treatments. Moreover, the complement reaction results suggested that the dramatic thrombocytopenia was probably due to platelet destruction after complement activation.ConclusionThis case suggests that it would be useful to perform a platelet complement reaction test before trastuzumab treatment in patients with HER2 breast cancer.

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Plasmapheresis in a case of acute kidney injury with severe hemolysis and thrombocytopenia due to hematotoxic (Russell's viper) snake bite

Cited by 3 publications

References 4 publications

A Guide to the Clinical Management of Vipera Snakebite in Italy

A Guide to the Clinical Management of Vipera Snakebite in Italy

Acute Hemolytic Anemia Caused by Loxoscelism Treated With Plasmapheresis: A Case Report

Acute thrombocytopenia induced by trastuzumab due to complement reaction: A case report

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