title: Haemolytic uremic syndrome a hitherto unreported complication of humpnosed viper envenomation.
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.
authors.affiliation: Internal Medicine, National Hospital, Colombo, Sri Lanka.
authors.forename: J Yudishdran
authors.initials: JY
authors.lastname: Mitrakrishnan
authors.affiliation: Internal Medicine, National Hospital, Colombo, Sri Lanka.
authors.forename: C Wijesiriwardena
authors.initials: CW
authors.lastname: Bandula
authors.affiliation: Internal Medicine, National Hospital, Colombo, Sri Lanka ; 8, Sri Vajirashrama Mawatha, Off Campbell Place, Colombo 10, Sri Lanka.
authors.forename: C Shivanthan
authors.initials: CS
authors.lastname: Mitrakrishnan
authors.affiliation: Internal Medicine, National Hospital, Colombo, Sri Lanka.
authors.forename: Kalum
authors.initials: K
authors.lastname: Somaratna
authors.affiliation: Internal Medicine, Colombo South Teaching Hospital, Dehimela, Sri Lanka.
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Jeyalakshmy
keywords: Acute kidney injury; Haemolytic uraemic syndrome; Humpnosed viper