title: Thrombotic microangiopathy due toViperidaebite: Two case reports.
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.
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: T
authors.initials: T
authors.lastname: Dineshkumar
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: J
authors.initials: J
authors.lastname: Dhanapriya
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: R
authors.initials: R
authors.lastname: Sakthirajan
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: K
authors.initials: K
authors.lastname: Thirumalvalavan
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: A A
authors.initials: AA
authors.lastname: Kurien
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: T
authors.initials: T
authors.lastname: Balasubramaniyan
authors.affiliation: Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors.forename: N
authors.initials: N
authors.lastname: Gopalakrishnan
keywords: Acute kidney injury; Viperidae; plasmapheresis; thrombotic microangiopathy