Venom-induced consumptive coagulopathy leading to thrombotic microangiopathy following Echis carinatus sochureki bite: is snake antivenom effective?

Author:

Parihar Vivek1,Mittal Aliza1ORCID,Vikarn Vishwajeet2,Didel Siyram1,Singh Kuldeep1

Affiliation:

1. Department of Paediatrics, AIIMS , Jodhpur 342005, India

2. Department of Pathology, AIIMS , Jodhpur 342005, India

Abstract

Abstract The incidence of thrombotic microangiopathy (TMA) following snake bite is reported to be ranging from 3.6 to 15%. We report a 10-year-old boy who developed TMA and due to venom-induced consumptive coagulopathy (VICC) despite receiving adequate and timely doses of snake antivenom following a bite of saw-scaled viper (Echis carinatus sochureki). VICC was managed by plasmapheresis. Though snake bite envenomation-associated renal complications are not uncommon, possibility of TMA should be considered early during management. Our patient developed TMA with subsequent acute cortical necrosis after saw-scaled viper bite despite an adequate and timely dose of snake antivenom which emphasizes the ineffectiveness of antivenom against the venom of given snake species leading to long-term complications.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Pediatrics, Perinatology and Child Health

Reference11 articles.

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3. Rediscovery of severe saw-scaled viper (Echis sochureki) envenoming in the Thar Desert Region of Rajasthan, India;Kochar;Wilderness Environ Med,2007

4. Thrombotic microangiopathy following saw-scaled viper (Echis carinatus) envenoming in Sri Lanka;Pirasath;SAGE Open Med Case Rep,2021

5. Thrombotic microangiopathy from Australian brown snake (Pseudonaja) envenoming;Isbister;Intern Med J,2007

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