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

J Trop Pediatr. 2022 Dec 5;69(1):fmac113. doi: 10.1093/tropej/fmac113.

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.

Keywords: TMA; VICC; acute cortical necrosis; snake antivenom.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Antivenins / therapeutic use
  • Humans
  • Snake Bites* / complications
  • Snake Bites* / therapy
  • Thrombotic Microangiopathies* / chemically induced
  • Thrombotic Microangiopathies* / therapy
  • Viper Venoms
  • Viperidae*

Substances

  • Antivenins
  • Viper Venoms