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Thrombotic microangiopathy in two tiger snake envenomations
1Intensive Care Department, The Northern Hospital, Epping, Victoria, Australia. andrew.casamento@nh.org.au
Anaesthesia and Intensive Care
|December 15, 2011
Summary
This study reports two cases of thrombotic microangiopathy following common tiger snake (Notechis scutatus) envenomation. These findings highlight a rare but serious complication of snakebite, emphasizing the need for awareness and further research.
Area of Science:
- Toxicology
- Hematology
- Nephrology
Background:
- Thrombotic microangiopathies (TMAs) are rare disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure.
- TMAs have been linked to envenomation from various snake species.
- The association between TMAs and common tiger snake (Notechis scutatus) envenomation has not been previously documented.
Purpose of the Study:
- To report the first two cases of thrombotic microangiopathy following envenomation by the common tiger snake (Notechis scutatus).
- To describe the clinical presentation, hematological findings, and renal involvement in these patients.
- To discuss the potential implications for management and understanding of snakebite-induced TMAs.
Main Methods:
- Case report of two patients presenting with symptoms post-envenomation.
- Clinical assessment including hematological parameters and renal function tests.
- Measurement of ADAMTS13 activity.
Main Results:
- Both patients exhibited classical TMA features: microangiopathic hemolytic anemia, thrombocytopenia, and renal failure within 48 hours of envenomation.
- Clinical presentation and recovery patterns were consistent with other reported cases of snakebite-associated TMAs.
- Normal ADAMTS13 activity was observed in both patients.
Conclusions:
- Envenomation by the common tiger snake (Notechis scutatus) can cause thrombotic microangiopathy.
- The findings suggest that TMAs in this context may not be primarily driven by severe ADAMTS13 deficiency.
- Further investigation is warranted to determine the efficacy of treatments like plasmapheresis in these specific cases.
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