Thrombotic microangiopathy and acute kidney injury in hump-nosed viper (Hypnale species) envenoming: A descriptive study in Sri Lanka

Can Fresh Frozen Plasma Prevent Acute Kidney Injury after Hump-Nosed Viper Bite?

“…Association of coagulopathy with AKI has been independently reported by several workers [14][15][16][17][18][19]. It is likely that common pathophysiological mechanisms are responsible for both these important systemic complications of hump-nosed viper bite.…”

“…Hump-nosed viper venom contains procoagulant, nephrotoxic, myotoxic and cytotoxic properties. AKI is caused primarily by nephrotoxicity rather than myoglobinuria or haemoglobinuria [15,19]. The procoagulant effects and venom induced consumption coagulopathy can also contribute to renal injury by the deposition of fibrin in the renal microcirculation and microvas-cular coagulation [19].…”

Hump-nosed Pit Viper Bite in Sri Lanka?Unravelling an Enigma

“…The mechanisms of renal injury have not been clearly elucidated. Both direct nephrotoxicity and adverse renal consequences of coagulopathy, such as venom induced consumption coagulopathy and thrombotic microangiopathy are implicated [14,15].…”

“…AKI is caused primarily by nephrotoxicity rather than myoglobinuria or haemoglobinuria. The procoagulant effects and venom induced consumption coagulopathy can also contribute to renal injury, by the deposition of fibrin in the renal microcirculation and microvascular coagulation [14]. Fibrinogen degradation products can perpetuate the bleeding tendency by its antihaemostatic effects.…”

“…Since the turn of the century, many have independently recognized the propensity of hump-nosed viper to give rise to coagulopathy and acute kidney injury (AKI) [9][10][11][12][13][14][15][16][17]. Several deaths due to systemic envenomation have also been reported [13,18].…”