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Nephrotoxicity Due to Snake Bite

Year 2012, Volume: 3 Issue: 1, 27 - 29, 01.01.2012

Abstract

Viperidae species snakes cause serious local tissue toxicity, and systemic poisoning states such as disseminated intravascular haemolysis. Rarely, acute kidney insufficiency may be seen due to snake bites. An eighteen year old male patient was transported to our clinic due to snake bite in the left f ankle. On admission he was administered three vials of antivenom with respect to his local and systemic poisoning signs. All coagulatioan parameters were normal after antivenom therapy and he was hospitalized. On the second day of hospitalisation his haematocrit and haemoglobin values were decreased and urea and creatinine values were increased and it was thought that these were due to intravascular haemolysis. Additional antivenom administered and fluid therapy was begun. During his hospitalisation renal function tests and hemogram of the patient were followed. He was discharged on the fifth day of hospitalisation with normal urea and creatinin levels. Intravascular haemolysis is an independent risk factor for nephrotoxicity in patients admitted with snake bites. Additional antivenom and aggressive fluid treatment may be beneficial in acute kidney insufficiency in these patients.

References

  • Açıkalın A, Gökel Y, Kuvandık G, Duru M, Köseoğlu Z, Satar S. The efficacy of low-dose antivenom therapy on morbidity and mortality in snakebite cases. Am J Emerg Med. 2008; 26: 402-7. [CrossRef]
  • Currie BJ. Snakebite in tropical Australia: a prospective study in the “Top End” of the Northern Territory. Med J Aust. 2004; 181: 693-7.
  • Ellenhorn MJ. Envenomation bites and stings. Ellerhorn’s Medi- cal Toxicology. Matthew J. Ellen-horn, MD, Editor. Williams and Wilkins. Baltimore. 2 th ed. 1997; p(72).1737-98.
  • Riley DB, Pizon EA, Ruha MA, Roberts JR, Otten EJ. Snakes and Other Reptiles. Goldfrank’s toxiko-logy. Goldfrank R L, MD, Edi- tor. Mc-graw Hill. 8 th ed. 2002;117: 1643-62
  • Attaphan G, Balaji VM, Naereethan U, Thirumalikolundusubra- manian P. Acute renal failure in snake envenomation: a large pro- spective study. Saudi Kidney Dis Transpl. 2008; 19: 404-10.
  • Alirol E, Sharma KS, Bowaskar SH, Kuch U, Chappuis F. Snake bite in South Asia: a review. PLoS Negl Trop Dis. 2010; 4: e603. [CrossRef]
  • Spiller HA, Bosse GM, Ryan ML. Use of antivenom for snakebites reported to United States poison centers. Am J Emerg Med. 2010; 28: 780-5. [CrossRef]
  • Zager RA, Gamelin LM. Pathogenetic mechanism in experimen- tal hemoglobinuria acute renal failure. Am J Physiol. 1985; 256: F446-55.
  • Zager RA, Foerder CA . Effects of inorganic iron and myoglobin on in vitro proximal tubule lipid peroxidation and cytotoxicity. J Clin Invest. 1992; 89 : 989-95. [CrossRef]

Yılan Isırmasına Bağlı Nefrotoksisite

Year 2012, Volume: 3 Issue: 1, 27 - 29, 01.01.2012

Abstract

Viperidae species snakes cause serious local tissue toxicity, and systemic poisoning states such as disseminated intravascular haemolysis. Rarely, acute kidney insufficiency may be seen due to snake bites. An eighteen year old male patient was transported to our clinic due to snake bite in the left f ankle. On admission he was administered three vials of antivenom with respect to his local and systemic poisoning signs. All coagulatioan parameters were normal after antivenom therapy and he was hospitalized. On the second day of hospitalisation his haematocrit and haemoglobin values were decreased and urea and creatinine values were increased and it was thought that these were due to intravascular haemolysis. Additional antivenom administered and fluid therapy was begun. During his hospitalisation renal function tests and hemogram of the patient were followed. He was discharged on the fifth day of hospitalisation with normal urea and creatinin levels. Intravascular haemolysis is an independent risk factor for nephrotoxicity in patients admitted with snake bites. Additional antivenom and aggressive fluid treatment may be beneficial in acute kidney insufficiency in these patients

References

  • Açıkalın A, Gökel Y, Kuvandık G, Duru M, Köseoğlu Z, Satar S. The efficacy of low-dose antivenom therapy on morbidity and mortality in snakebite cases. Am J Emerg Med. 2008; 26: 402-7. [CrossRef]
  • Currie BJ. Snakebite in tropical Australia: a prospective study in the “Top End” of the Northern Territory. Med J Aust. 2004; 181: 693-7.
  • Ellenhorn MJ. Envenomation bites and stings. Ellerhorn’s Medi- cal Toxicology. Matthew J. Ellen-horn, MD, Editor. Williams and Wilkins. Baltimore. 2 th ed. 1997; p(72).1737-98.
  • Riley DB, Pizon EA, Ruha MA, Roberts JR, Otten EJ. Snakes and Other Reptiles. Goldfrank’s toxiko-logy. Goldfrank R L, MD, Edi- tor. Mc-graw Hill. 8 th ed. 2002;117: 1643-62
  • Attaphan G, Balaji VM, Naereethan U, Thirumalikolundusubra- manian P. Acute renal failure in snake envenomation: a large pro- spective study. Saudi Kidney Dis Transpl. 2008; 19: 404-10.
  • Alirol E, Sharma KS, Bowaskar SH, Kuch U, Chappuis F. Snake bite in South Asia: a review. PLoS Negl Trop Dis. 2010; 4: e603. [CrossRef]
  • Spiller HA, Bosse GM, Ryan ML. Use of antivenom for snakebites reported to United States poison centers. Am J Emerg Med. 2010; 28: 780-5. [CrossRef]
  • Zager RA, Gamelin LM. Pathogenetic mechanism in experimen- tal hemoglobinuria acute renal failure. Am J Physiol. 1985; 256: F446-55.
  • Zager RA, Foerder CA . Effects of inorganic iron and myoglobin on in vitro proximal tubule lipid peroxidation and cytotoxicity. J Clin Invest. 1992; 89 : 989-95. [CrossRef]
There are 9 citations in total.

Details

Other ID JA73UE24CP
Journal Section Research Article
Authors

Ayça Açıkalın This is me

Müge Gülen This is me

Selen Acehan This is me

Cem Kazğan This is me

Publication Date January 1, 2012
Submission Date January 1, 2012
Published in Issue Year 2012 Volume: 3 Issue: 1

Cite

APA Açıkalın, A., Gülen, M., Acehan, S., Kazğan, C. (2012). Yılan Isırmasına Bağlı Nefrotoksisite. Journal of Emergency Medicine Case Reports, 3(1), 27-29.
AMA Açıkalın A, Gülen M, Acehan S, Kazğan C. Yılan Isırmasına Bağlı Nefrotoksisite. Journal of Emergency Medicine Case Reports. January 2012;3(1):27-29.
Chicago Açıkalın, Ayça, Müge Gülen, Selen Acehan, and Cem Kazğan. “Yılan Isırmasına Bağlı Nefrotoksisite”. Journal of Emergency Medicine Case Reports 3, no. 1 (January 2012): 27-29.
EndNote Açıkalın A, Gülen M, Acehan S, Kazğan C (January 1, 2012) Yılan Isırmasına Bağlı Nefrotoksisite. Journal of Emergency Medicine Case Reports 3 1 27–29.
IEEE A. Açıkalın, M. Gülen, S. Acehan, and C. Kazğan, “Yılan Isırmasına Bağlı Nefrotoksisite”, Journal of Emergency Medicine Case Reports, vol. 3, no. 1, pp. 27–29, 2012.
ISNAD Açıkalın, Ayça et al. “Yılan Isırmasına Bağlı Nefrotoksisite”. Journal of Emergency Medicine Case Reports 3/1 (January 2012), 27-29.
JAMA Açıkalın A, Gülen M, Acehan S, Kazğan C. Yılan Isırmasına Bağlı Nefrotoksisite. Journal of Emergency Medicine Case Reports. 2012;3:27–29.
MLA Açıkalın, Ayça et al. “Yılan Isırmasına Bağlı Nefrotoksisite”. Journal of Emergency Medicine Case Reports, vol. 3, no. 1, 2012, pp. 27-29.
Vancouver Açıkalın A, Gülen M, Acehan S, Kazğan C. Yılan Isırmasına Bağlı Nefrotoksisite. Journal of Emergency Medicine Case Reports. 2012;3(1):27-9.