E-ISSN 2231-170X | ISSN 2231-1696
 
2024, Vol: 14, Issue: 1
14 / 1Current Issue Online FirstArchiveAims and ScopeAbstracting & IndexingMost Accessed ArticlesMost Downloaded ArticlesMost Cited Articles

Case Report
Online Published: 10 Sep 2024
 


A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite

Akhilendra Bahadur Khare, Arun Tyagi, Saurabh Birajdar, Sharad Garudkar, Awani Kumar Srivastava.


Abstract
Russell’s viper is one of the ‘big four’ most dangerous poisonous snakes in India. The farmer and snakes, especially the Russell's viper, coexist in tenuous relationship in the ecosystem. The clinical manifestations of viper bite are localized pain and swelling, coagulopathy, and renal impairment. The venom induced consumption coagulopathy (VICC) following Russell’s viper bite can result in a syndrome consistent with thrombotic microangiopathy (TMA), manifesting with thrombocytopenia, microangiopathic hemolytic anemia (MAHA) and acute kidney injury (AKI). TMA is rarely reported as a complication of Russell’s viper envenoming. Our patient, a farmer, was bitten by Russell’s viper and was brought to a nearby hospital within an hour. He was administered anti-snake venom (ASV) and supportive therapy. As his renal function declined, he was transferred to our hospital. He developed thrombocytopenia, and MAHA as evidenced by progressive anemia, schistocytes on peripheral smear, increased levels of lactate dehydrogenase (LDH), and AKI unresponsive to fluid management and diuretic administration. He was managed with sustained low-efficiency dialysis (SLED) and therapeutic plasma exchange (TPE). After three cycles of TPE and seven cycles of SLED over the next three weeks, the patient recovered completely and has been asymptomatic for more than six-months during follow up. The case is reported for rarity of TMA in the Russell’s viper envenomation, and the role of TPE in such cases.

Key words: Acute kidney injury, Plasmapheresis, Snakebite, Thrombotic microangiopathy, Venom induced consumptive coagulopathy


 
ARTICLE TOOLS
Abstract
PDF Fulltext
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Akhilendra Bahadur Khare
Articles by Arun Tyagi
Articles by Saurabh Birajdar
Articles by Sharad Garudkar
Articles by Awani Kumar Srivastava
on Google
on Google Scholar


How to Cite this Article
Pubmed Style

Khare AB, Tyagi A, Birajdar S, Garudkar S, Srivastava AK. A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite. J Med Allied Sci. Online First: 10 Sep, 2024. doi:10.5455/jmas.175438

Web Style

Khare AB, Tyagi A, Birajdar S, Garudkar S, Srivastava AK. A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite. https://jmas.in/?mno=175438 [Access: September 12, 2024]. doi:10.5455/jmas.175438

AMA (American Medical Association) Style

Khare AB, Tyagi A, Birajdar S, Garudkar S, Srivastava AK. A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite. J Med Allied Sci. Online First: 10 Sep, 2024. doi:10.5455/jmas.175438


Vancouver/ICMJE Style

Khare AB, Tyagi A, Birajdar S, Garudkar S, Srivastava AK. A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite. J Med Allied Sci, [cited September 12, 2024]; Online First: 10 Sep, 2024. doi:10.5455/jmas.175438


Harvard Style

Khare, A. B., Tyagi, . A., Birajdar, . S., Garudkar, . S. & Srivastava, . A. K. (2024) A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite. J Med Allied Sci, Online First: 10 Sep, 2024. doi:10.5455/jmas.175438


Turabian Style

Khare, Akhilendra Bahadur, Arun Tyagi, Saurabh Birajdar, Sharad Garudkar, and Awani Kumar Srivastava. 2024. A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite. Journal of Medical and Allied Sciences, Online First: 10 Sep, 2024. doi:10.5455/jmas.175438


Chicago Style

Khare, Akhilendra Bahadur, Arun Tyagi, Saurabh Birajdar, Sharad Garudkar, and Awani Kumar Srivastava. "A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite." Journal of Medical and Allied Sciences Online First: 10 Sep, 2024. doi:10.5455/jmas.175438


MLA (The Modern Language Association) Style

Khare, Akhilendra Bahadur, Arun Tyagi, Saurabh Birajdar, Sharad Garudkar, and Awani Kumar Srivastava. "A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite." Journal of Medical and Allied Sciences Online First: 10 Sep, 2024. Web. 12 Sep 2024 doi:10.5455/jmas.175438


APA (American Psychological Association) Style

Khare, A. B., Tyagi, . A., Birajdar, . S., Garudkar, . S. & Srivastava, . A. K. (2024) A case of acquired thrombotic microangiopathy secondary to Russell’s viper bite. Journal of Medical and Allied Sciences, Online First: 10 Sep, 2024. doi:10.5455/jmas.175438


Author LoginReviewer LoginAbout PublisherEditorial Review PolicyEditorial & Peer Review ProcessConflict of Interest PolicyAdvertising PolicyLicense InformationCopyright Information

About Journal of Medical and Allied Sciences

Welcome to the Journal of Medical and Allied Sciences (JMAS), an official international publication of Deccan College of Medical Sciences, for rapid publi ... Read more.



For best results, please use Internet Explorer or Google Chrome.

Contact Information


By regular mail/speed post/courier

Dr. Kazi Mudabbir Ahmed
Editor, JMAS,
Deccan College of Medical Sciences,
DMRL ‘X’ Road, Kanchanbagh (PO),
Hyderabad-500 058, Telangana, India.

By email: editorialoffice@jmas.in

By phone: +91 40 24340225, 24340129

By Mobile: +91-8522828349

By fax: +91 40 24340235