Department of Medicine, Royal Medical Services, Amman, Jordan.
Department of Nursing, Royal Medical Services, Amman, Jordan.
Am J Case Rep. 2020 Apr 15;21:e922000. doi: 10.12659/AJCR.922000.
BACKGROUND Consumption coagulopathy post envenomation is one the most common complications after a snakebite. It occurs secondary to activation of a coagulation cascade by snake venom and could be followed by a syndrome consistent with thrombotic microangiopathy. The efficacy of plasma exchange for the treatment of thrombotic microangiopathy post envenomation is a matter of debate. CASE REPORT We reported the case of a 50-year-old male who had Arabian saw-scaled viper envenomation. He developed venom induced coagulopathy that improved within 24 hours of antivenom therapy. He subsequently developed micro-angiopathic hemolytic anemia, thrombocytopenia, and renal failure that was consistent with thrombotic microangiopathy. The patient was treated by plasma exchange and hemodialysis. He made a full recovery and was discharged after 4 weeks. CONCLUSIONS This case report supports plasmapheresis as an option for management of a patient who develops thrombotic microangiopathy secondary to snake bite, especially those who do not improve with antivenom and supportive therapy.
蛇伤后消耗性凝血病是最常见的并发症之一。它是由蛇毒激活凝血级联反应引起的，随后可能出现符合血栓性微血管病的综合征。血浆置换治疗蛇伤后血栓性微血管病的疗效存在争议。
我们报告了一例 50 岁男性被阿拉伯锯鳞蝰蛇咬伤的病例。他发生了蛇毒诱导的凝血病，在抗蛇毒治疗后 24 小时内得到改善。随后他出现微血管性溶血性贫血、血小板减少和肾衰竭，符合血栓性微血管病。患者接受了血浆置换和血液透析治疗。他完全康复，4 周后出院。
本病例报告支持血浆置换作为蛇伤后发生血栓性微血管病患者的治疗选择，尤其是那些对抗蛇毒和支持治疗无反应的患者。
