Hypnale coagulopathy: snake envenomation of a different kind

Abstract

Hypnale hypnale is a small pit viper that is known as the hump-nosed pit viper (HNV) or ‘Merrem’s hump-nosed pit viper’ and is endemic to Sri Lanka and the Western Ghats of South India. Previously, it was thought that this viper bite would result in mild systemic or local envenomation, however, we now know that HNV bites could cause severe systemic toxicity and mortality. The most common systemic toxicity of this viper envenomation is coagulopathy, which is known as ‘Hypnale coagulopathy’. Hypnale coagulopathy is quite different from the haemotoxicity caused by other vipers. In this paper, an effort has been made to discuss the unique and unpredictable nature of this coagulopathy due to Hypnale envenomation.