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The kidney in tropical snakebite

V Sitprija, V Boonpucknavig

    Clinical Nephrology
    |September 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Snakebite envenomation causes significant renal pathology, including glomerular and tubular damage. Russell's viper and seasnake bites are particularly associated with severe renal failure and necrosis.

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    Area of Science:

    • Nephrology
    • Toxicology
    • Pathology

    Background:

    • Snakebite envenomation is a significant health concern, particularly in tropical regions.
    • Tropical poisonous snakes pose a threat due to their venom's complex composition and potential for severe systemic effects.
    • Renal complications are a known, yet variably understood, consequence of specific snakebite incidents.

    Purpose of the Study:

    • To investigate the spectrum of renal pathological changes in patients following bites from various tropical poisonous snakes.
    • To correlate specific snake venoms with distinct patterns of renal injury observed through renal biopsy.
    • To elucidate the mechanisms of renal damage in snakebite envenomation.

    Main Methods:

    • Renal biopsy analysis in 31 patients with tropical snakebite envenomation.

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  • Histopathological examination including light microscopy and immunofluorescence.
  • Electron microscopy to identify ultrastructural changes in renal tissues.
  • Classification of snakes involved: seasnake, cobra, green-pit viper, and Russell's viper.

    • Main Results:

    • Renal failure was exclusively observed in seasnake and Russell's viper bites.
    • Glomerular mesangial proliferation and immune complex deposition (IgM, C3) occurred in cobra, green-pit viper, and Russell's viper bites.
    • Fibrin deposition and tubular necrosis were noted in green-pit viper and Russell's viper cases, with severity varying by snake type.
    • Vascular changes, including arteritis and thrombophlebitis, were associated with Russell's viper and green-pit viper bites, respectively, with C3 deposition in affected vessels.

    Conclusions:

    • Different tropical snake venoms induce distinct renal pathological profiles.
    • Russell's viper and seasnake envenomation present a high risk for severe renal failure and necrosis.
    • Understanding these specific pathological changes is crucial for targeted treatment and improved patient outcomes in snakebite management.