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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Acute kidney injury induced by thrombotic microangiopathy in two cases of Bothrops envenomation

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Author(s):
Malaque, C. M. S. [1, 2] ; Duayer, I. F. [1] ; Santoro, M. L. [3]
Total Authors: 3
Affiliation:
[1] Emilio Ribas Inst Infectol, Sao Paulo - Brazil
[2] Vital Brazil Hosp, Butantan Inst, Av Dr Vital Brasil 1500, BR-05503900 Sao Paulo - Brazil
[3] Butantan Inst, Lab Pathophysiol, Sao Paulo - Brazil
Total Affiliations: 3
Document type: Journal article
Source: CLINICAL TOXICOLOGY; v. 57, n. 3, p. 213-216, MAR 4 2019.
Web of Science Citations: 0
Abstract

Context: Bothrops snakes are the most frequent agents of snakebites in South and Central America. Acute kidney injury (AKI) is one of its complications and has multifactorial origin. Thrombotic microangiopathy (TMA)-induced AKI in snakebites is uncommon and is not described in Bothrops envenomation. Case details: We report two cases of patients bitten by young Bothrops jararaca who developed AKI induced by TMA. Both patients evolved with mild envenomation and received the specific antivenom within 4 h after the snakebite. None of them had hypotension or shock, bleeding or secondary infection. Patient 1 (P1) was diabetic and using oral hypoglycemic drugs, and patient 2 (P2) was hypertensive without regular use of medication. On admission, both patients had levels of fibrinogen lower than 35 mg/dL, D-dimer higher than 10,000 ng/mL. They evolved with AKI, thrombocytopenia, normal coagulation assays, anemia, lactate dehydrogenase (LDH) elevation, low haptoglobin levels, negative direct antiglobulin test, and presence of schizocytes in peripheral blood. Only P1 required renal replacement therapy, and plasmapheresis was not required. Both patients were discharged and did not require outpatient dialysis, and subsequently had normal creatinine levels. Discussion: TMA may occur in Bothrops jararaca envenomation, even in mild cases that received early specific antivenom. (AU)

FAPESP's process: 13/25177-0 - Involvement of Von Willebrand factor in hemostatic disturbances induced by Bothrops jararaca snake venom: experimental study
Grantee:Marcelo Larami Santoro
Support Opportunities: Regular Research Grants