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.
References
De Silva A, Wijekoon ASB, Jayasena L (1996) Haemostatic dysfunction and acute renal failure following envenoming by Merrem’s hump nosed viper. Transactions of royal college of tropical medicine and hygiene 90:293–295
Kularatne SA, Ratnatunga N (1999) Severe systemic effects of Merrem’s hump-nosed viper bite. The Ceylon Med J 44:169–170
Ibister GK (2010) Snakebite doesn’t cause disseminated intravascular coagulation: coagulopathy and thrombotic microangiopathy in snake envenoming. Semin Thromb Hemost 36:444–451
Premawardena AP, Seneviratne SL, Gunatilake SB, de Silva HJ (1998) Excessive fibrinolysis: the coagulopathy following Merrem’s hump-nosed viper (Hypnale hypnale)bites. Am J Trop Med Hyg 58:821–823
George JN, Gilcher RO, Smith JW, Chandler L, Duvall D, Ellis C (1998) Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: diagnosis and management. J Clin Apheresis 13:120–125
George JN (2006) Clinical practice. Thrombotic thrombocytopenic purpura. N Engl J Med 354:1927–1935
Koster FT, Boonpucknavig V, Sujaho S, Gilman RH, Rahaman MM (1984) Renal histopathology in the hemolytic-uremic syndrome following shigellosis. Clin Nephrol 21:126–133
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Mitrakrishnan, J.Y., Bandula, C.W., Mitrakrishnan, C.S. et al. Haemolytic Uremic Syndrome a Hitherto Unreported Complication of Humpnosed Viper Envenomation. Indian J Hematol Blood Transfus 29, 116–118 (2013). https://doi.org/10.1007/s12288-012-0156-9
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DOI: https://doi.org/10.1007/s12288-012-0156-9