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Clinicopathological study of acute renal failure following viperine snake bite.

Authors
  • Merchant, M R
  • Khanna, U B
  • Almeida, A F
  • Acharya, V N
  • Mittal, B V
Type
Published Article
Journal
The Journal of the Association of Physicians of India
Publication Date
Jul 01, 1989
Volume
37
Issue
7
Pages
430–433
Identifiers
PMID: 2613661
Source
Medline
License
Unknown

Abstract

Fifty patients of acute renal failure following Viperine snake bite were studied. Oliguria (100%), local swelling (48%) and bleeding tendencies (42%) were the predominant clinical features encountered. Of the 25 patients in whom detailed coagulation studies were done, 24 patients had disseminated intravascular coagulation (DIC) and 1 had primary fibrinolysis. DIC was commoner with Russell's viper bite (62%) in comparison to Echis carinatus bites (40%). Renal histology obtained in 29 cases revealed tubular necrosis (35%), cortical necrosis (24%) tubular degeneration (17%) and glomerular changes (17%). Ballooning of glomerular capillaries (59%), splitting of glomerular basement membrane (40.7%), swelling of endothelial cells (29.6%), and focal proliferation of mesangial cells (17%) were the significant glomerular changes encountered. 20 (40%) patients succumbed, DIC (50%), irreversible shock (30%) and septicaemia (20%) being the immediate causes of death. Development of oliguria within 24 hours of snake bite and cortical necrosis were associated with higher mortality.

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