Sameeh Khan.
Acute renal failure following snake bite-Case reports and review.
J Pak Inst Med Sci Jan ;7(2)8(1,2):539-41.

This illustrates two cases of acute renal failure following snake bite presented to Department of Neprhology, Pakistan Institute of Medical Sciences. One presented with disseminated intravascular coagulation and prolonged renal failure requiring renal biopsy showing tubulo-interstitial nephritis with infiltration of eosinophils, mono nuclear and plasma cells. The other case without DIC followed the usual clinical course suggestive of acute tubular necrosis. The pathogenesis, pathology and therapy along with literature review is discussed.

Case No. 1: Mr. B.A. 24 year old with 3 day history of snake bite presented one day prior to admission with hemetemesis, hematuria followed by anuria and deranged renal function. On physical examination, pertinent findings were T 101F, BP 160/100, pedal, facial and periobital edema, subconjunctival haemorrhages without petichae and two fang marks on lateral side of left foot. Laboratory Investigations are Hemoglobin 9.1 gm/dl TLC 13,000 with normal differential, platelet count 43,000 PT 36 Sec/control of 12 APTT 56 Sec/control 30. FDP more than 40 kg/dl, Na 143, K 4.5. Urea 295 mg/dl, creatinine 7.0.

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