Clinicopathological study of acute renal failure following viperine snake bite.
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.
Merchant
M R
MR
Khanna
U B
UB
Almeida
A F
AF
Acharya
V N
VN
Mittal
B V
BV
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000473:pathology; D000328:Adult; D005260:Female; D005920:Glomerular Mesangium / Q000473:pathology; D006801:Humans; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced / Q000473:pathology; D008297:Male; D014757:Viper Venoms / Q000506:poisoning*
D014757:Viper Venoms