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Acute interstitial nephritis in snake bite

V Sitprija, R Suvanpha, C Pochanugool

    The American Journal of Tropical Medicine and Hygiene
    |March 1, 1982
    PubMed
    Summary
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    Russell's viper bites can cause acute kidney injury with prolonged low urine output. Renal biopsy showed interstitial nephritis, expanding the known kidney effects of snake envenomation.

    Area of Science:

    • Nephrology
    • Toxicology
    • Pathology

    Background:

    • Snakebite envenomation is a significant health concern globally.
    • Russell's viper (Vipera russellii siamensis) bites are known to cause systemic toxicity, including acute kidney injury.

    Observation:

    • A patient presented with acute renal failure and prolonged oliguria after a Russell's viper bite.
    • Renal biopsy was performed to investigate the cause of kidney dysfunction.

    Findings:

    • The renal biopsy revealed acute tubular necrosis and mesangial proliferation, consistent with known viper envenomation effects.
    • Notably, interstitial nephritis was also observed, a finding not typically emphasized in Russell's viper bite-induced nephrotoxicity.
    • No immunoglobulin deposition was detected, suggesting a non-immune complex-mediated mechanism for the observed renal pathology.

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    Implications:

    • This case expands the spectrum of renal pathology associated with Russell's viper bites.
    • The presence of interstitial nephritis warrants further investigation into its pathogenesis and clinical significance in snakebite victims.
    • Understanding these diverse renal changes is crucial for accurate diagnosis and management of acute kidney injury following snake envenomation.