蛇咬伤后急性间质性肾炎：单中心经验

Acute Interstitial Nephritis Following Snake Envenomation: A Single-Center Experience.

作者信息

Priyamvada P S, Shankar Vijay, Srinivas B H, Rajesh N G, Parameswaran Sreejith

机构信息

Departments of Nephrology (Drs Priyamvada, Shankar, and Parameswaran) and Pathology (Drs Srinivas and Rajesh), Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

Wilderness Environ Med. 2016 Jun;27(2):302-6. doi: 10.1016/j.wem.2015.12.009. Epub 2016 Mar 9.

DOI:10.1016/j.wem.2015.12.009

PMID:26970860

Abstract

OBJECTIVES

To identify the clinical and histopathological characteristics of patients who develop acute interstitial nephritis (AIN) following snake envenomation.

METHODS

A retrospective analysis of patients diagnosed with snake envenomation-induced AIN from October 2013 to November 2014.

RESULTS

After snake envenomation, 88 patients developed acute kidney injury (AKI). Biopsies were performed on 7 patients due to nonrecovery of kidney function. Among these, 5 patients had AIN. Thus, AIN accounted for 5.7% of snakebite-related acute kidney injury. All patients had severe envenomation at presentation and had prolonged renal failure. Kidney biopsy found a mixed infiltrate composed of predominantly lymphocytes, with variable proportions of other cells including eosinophils neutrophils and plasma cells. The response rate to corticosteroids was 80%.

CONCLUSIONS

AIN after snake bite is not uncommon. AIN needs to be considered in patients with persistent renal failure after snake envenomation. Identifying this complication is of utmost importance because of the potentially reversible nature.

摘要

目的

确定蛇咬伤后发生急性间质性肾炎（AIN）患者的临床和组织病理学特征。

方法

对2013年10月至2014年11月诊断为蛇咬伤所致AIN的患者进行回顾性分析。

结果

蛇咬伤后，88例患者发生急性肾损伤（AKI）。因肾功能未恢复，对7例患者进行了活检。其中，5例患者患有AIN。因此，AIN占蛇咬伤相关急性肾损伤的5.7%。所有患者就诊时均有严重中毒，且肾衰竭持续时间长。肾活检发现以淋巴细胞为主的混合浸润，伴有不同比例的其他细胞，包括嗜酸性粒细胞、中性粒细胞和浆细胞。对皮质类固醇的反应率为80%。