Thrombotic Microangiopathy Due to Bite: Two Case Reports

Overview

Journal Indian J Nephrol

Specialty Nephrology

Date 2017 Mar 31

PMID 28356675

Citations 15

Authors

T Dineshkumar

J Dhanapriya

R Sakthirajan

K Thirumalvalavan

A A Kurien

T Balasubramaniyan

N Gopalakrishnan

Affiliations

Soon will be listed here.

Abstract

Snake bite is mainly an occupational hazard and causes serious health problems in rural India. Acute kidney injury (AKI) occurs in 5-30% cases. Renal pathologic findings include acute tubular necrosis, cortical necrosis, interstitial nephritis, glomerulonephritis, and vasculitis. Thrombotic microangiopathy (TMA) occurrence after a snake bite is reported rarely. Here, we present two patients who developed TMA after viper bite treated with hemodialysis and plasmapheresis. Renal biopsy showed fibrin thrombi in glomeruli and arterioles with cortical necrosis. One patient progressed to end-stage renal disease and other was lost to follow-up. TMA should be considered as a possible pathogenesis of AKI after snake bite. The role of plasma exchanges in snake bite TMA is yet to be defined.

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