因尖吻蝮蛇咬伤导致急性肾损伤和弥散性血管内凝血缓解后出现的IV型肾小管酸中毒。
Type IV renal tubular acidosis following resolution of acute kidney injury and disseminated intravascular coagulation due to hump-nosed viper bite.
作者信息
Karunarathne S, Udayakumara Y, Govindapala D, Fernando H
机构信息
Department of Clinical Medicine, National Hospital, Colombo, Sri Lanka.
出版信息
Indian J Nephrol. 2013 Jul;23(4):294-6. doi: 10.4103/0971-4065.114476.
Abstract
Hump-nosed viper bite can cause acute kidney injury (AKI) and disseminated intravascular coagulation. In some patients, it can cause chronic kidney disease necessitating life-long renal replacement therapy. Lack of effective antivenom makes the management of these patients difficult. A 51-year-old Sri Lankan male was admitted with AKI and disseminated intravascular coagulation following a hump-nosed viper bite. He made a complete recovery with blood product support and hemodialysis. Renal biopsy was performed as his renal recovery was prolonged which revealed patchy tubular atrophy and interstitial inflammation suggestive of subacute interstitial nephritis. Later, he presented with hyperkalemic paralysis and acidosis. A diagnosis of late onset type 4 renal tubular acidosis was made and he responded well to a course of fludrocortisone.
摘要
尖吻蝮蛇咬伤可导致急性肾损伤（AKI）和弥散性血管内凝血。在一些患者中，它可导致慢性肾病，需要终身肾脏替代治疗。缺乏有效的抗蛇毒血清使得这些患者的治疗变得困难。一名51岁的斯里兰卡男性在被尖吻蝮蛇咬伤后因急性肾损伤和弥散性血管内凝血入院。在血液制品支持和血液透析下，他完全康复。由于他的肾脏恢复时间延长，进行了肾活检，结果显示有散在的肾小管萎缩和间质炎症，提示为亚急性间质性肾炎。后来，他出现了高钾性麻痹和酸中毒。诊断为迟发性4型肾小管酸中毒，他对氟氢可的松疗程反应良好。
相似文献
1
Type IV renal tubular acidosis following resolution of acute kidney injury and disseminated intravascular coagulation due to hump-nosed viper bite.因尖吻蝮蛇咬伤导致急性肾损伤和弥散性血管内凝血缓解后出现的IV型肾小管酸中毒。
Indian J Nephrol. 2013 Jul;23(4):294-6. doi: 10.4103/0971-4065.114476.
2
Acute myocardial infarction associated with thrombotic microangiopathy following a hump-nosed viper bite: a case report.尖吻蝮蛇咬伤后并发血栓性微血管病的急性心肌梗死：一例报告
J Med Case Rep. 2017 Oct 30;11(1):305. doi: 10.1186/s13256-017-1484-z.
3
Transient distal renal tubular acidosis following hump nosed viper bite: Two cases from Sri Lanka.
Saudi J Kidney Dis Transpl. 2016 Sep-Oct;27(5):1018-1020. doi: 10.4103/1319-2442.190879.
4
Thrombotic microangiopathy and acute kidney injury in hump-nosed viper (Hypnale species) envenoming: a descriptive study in Sri Lanka.烙铁头蛇属（Hypnale 种）咬伤致血栓性微血管病和急性肾损伤：斯里兰卡的描述性研究。
Toxicon. 2012 Jul;60(1):61-5. doi: 10.1016/j.toxicon.2012.03.015. Epub 2012 Mar 26.
5
A life-threatening complication due to pulmonary haemorrhage following hump-nosed viper bite.肺出血致喘吻蝮咬伤后生命威胁的并发症。
BMC Pulm Med. 2020 Feb 7;20(1):35. doi: 10.1186/s12890-020-1070-9.
6
Rare cardiac sequelae of a hump-nosed viper bite.尖吻蝮蛇咬伤罕见的心脏后遗症。
BMC Res Notes. 2015 Sep 14;8:437. doi: 10.1186/s13104-015-1426-z.
7
Acute ischemic stroke: a rare complication of hump-nosed pit viper (Hypnale spp.) bite: a case report.急性缺血性脑卒中：烙铁头咬伤罕见并发症：病例报告。
J Med Case Rep. 2022 Jun 4;16(1):218. doi: 10.1186/s13256-022-03442-3.
8
Hump-Nosed Viper Bite-Associated Thrombotic Thrombocytopenic Purpura: A Rare Complication.尖吻蝮咬伤相关的血栓性血小板减少性紫癜：一种罕见的并发症。
Cureus. 2024 Mar 9;16(3):e55873. doi: 10.7759/cureus.55873. eCollection 2024 Mar.
9
Clinicopathological spectrum of snake bite-induced acute kidney injury from India.印度蛇咬伤所致急性肾损伤的临床病理谱
World J Nephrol. 2017 May 6;6(3):150-161. doi: 10.5527/wjn.v6.i3.150.
10
Parallels between Russell's viper (Daboia russelii) and hump-nosed viper (Hypnale species) bites in the central hills of Sri Lanka amidst the heavy burden of unidentified snake bites.在斯里兰卡中部山区，由于大量未识别的蛇咬伤，罗素的蝰蛇（Daboia russelii）和驼峰鼻蝰（Hypnale species）咬伤之间存在相似之处。
Asian Pac J Trop Med. 2011 Jul;4(7):564-7. doi: 10.1016/S1995-7645(11)60147-8.
引用本文的文献
1
Indian Polyvalent Antivenom Accelerates Recovery From Venom-Induced Consumption Coagulopathy (VICC) in Sri Lankan Russell's Viper () Envenoming.印度多价抗蛇毒血清可加速斯里兰卡锯鳞蝰蛇咬伤所致的蛇毒诱导的消耗性凝血病（VICC）的恢复。
Front Med (Lausanne). 2022 Mar 7;9:852651. doi: 10.3389/fmed.2022.852651. eCollection 2022.
2
Snakebite associated thrombotic microangiopathy: a systematic review of clinical features, outcomes, and evidence for interventions including plasmapheresis.蛇咬伤相关性血栓性微血管病：临床特征、结局及包括血浆置换在内的干预措施的系统评价。
PLoS Negl Trop Dis. 2020 Dec 8;14(12):e0008936. doi: 10.1371/journal.pntd.0008936. eCollection 2020 Dec.
3
Endocrine and Metabolic Manifestations of Snakebite Envenoming.蛇伤的内分泌和代谢表现。
Am J Trop Med Hyg. 2020 Oct;103(4):1388-1396. doi: 10.4269/ajtmh.20-0161.
4
Role of biomarkers of nephrotoxic acute kidney injury in deliberate poisoning and envenomation in less developed countries.肾毒性急性肾损伤生物标志物在欠发达国家蓄意中毒和中毒中的作用。
Br J Clin Pharmacol. 2015 Jul;80(1):3-19. doi: 10.1111/bcp.12601. Epub 2015 May 28.
5
A study of snake bite among children presenting to a paediatric ward in the main Teaching Hospital of North Central province of Sri Lanka.对前往斯里兰卡中北部省主要教学医院儿科病房就诊的儿童蛇咬伤情况的一项研究。
BMC Res Notes. 2014 Jul 29;7:482. doi: 10.1186/1756-0500-7-482.
本文引用的文献
1
Mechanisms in hyperkalemic renal tubular acidosis.高钾性肾小管酸中毒的机制。
J Am Soc Nephrol. 2009 Feb;20(2):251-4. doi: 10.1681/ASN.2008020166. Epub 2009 Feb 4.
2
Frequent and potentially fatal envenoming by hump-nosed pit vipers (Hypnale hypnale and H. nepa) in Sri Lanka: lack of effective antivenom.斯里兰卡尖吻蝮（Hypnale hypnale和H. nepa）频繁致伤且可能致命：缺乏有效的抗蛇毒血清。
Trans R Soc Trop Med Hyg. 2008 Nov;102(11):1120-6. doi: 10.1016/j.trstmh.2008.03.023. Epub 2008 May 2.
3
Severe systemic effects of Merrem's hump-nosed viper bite.锯鳞蝰蛇咬伤的严重全身影响。
Ceylon Med J. 1999 Dec;44(4):169-70.
4
Excessive fibrinolysis: the coagulopathy following Merrem's hump-nosed viper (Hypnale hypnale) bites.纤维蛋白溶解过度：默里氏角蝰（Hypnale hypnale）咬伤后的凝血病
Am J Trop Med Hyg. 1998 Jun;58(6):821-3. doi: 10.4269/ajtmh.1998.58.821.
5
Coagulopathy and fibrinolysis following the bite of a hump-nosed viper (Hypnale hypnale).
Trans R Soc Trop Med Hyg. 1996 May-Jun;90(3):293. doi: 10.1016/s0035-9203(96)90257-6.
6
Haemostatic dysfunction and acute renal failure following envenoming by Merrem's hump-nosed viper (Hypnale hypnale) in Sri Lanka: first authenticated case.斯里兰卡墨雷氏角鼻蝰（Hypnale hypnale）咬伤后出现的止血功能障碍和急性肾衰竭：首例经证实的病例。
Trans R Soc Trop Med Hyg. 1994 Mar-Apr;88(2):209-12. doi: 10.1016/0035-9203(94)90301-8.
7
Death from snake-bite in Anuradhapura District.阿努拉德普勒区的蛇咬致死事件。
Ceylon Med J. 1983 Sep;28(3):163-9.
8
Epidemiology of snake-bite in Sri Lanka: a review.斯里兰卡蛇咬伤的流行病学：综述
Ceylon Med J. 1983 Sep;28(3):144-54.
9
Bilateral cortical necrosis of the kidneys following snakebite.蛇咬伤后双侧肾皮质坏死。
Postgrad Med J. 1970 Jul;46(537):449-51. doi: 10.1136/pgmj.46.537.449.
10
Effects of heparin-induced aldosterone deficiency on renal function in patients with chronic glomerulonephritis.肝素诱导的醛固酮缺乏对慢性肾小球肾炎患者肾功能的影响。
Nephrol Dial Transplant. 1987;2(4):219-23.
Zotero 插件