Thrombotic Microangiopathy in Snakebite Envenomation

Abstract

Acute kidney Injury and Venom Induced consumption coagulopathy are known complications of snake bite envenomation. A small subset of such snakebite patients may develop thrombotic microangiopathy (TMA) which may go unrecognized if not looked for. If anaemia, thrombocytopenia and renal failure occurs despite normal coagulation parameters, a peripheral smear to look for haemolysis is warranted to identify the condition. Controversies regarding treatment with therapeutic plasma exchange exists. Early diagnosis and initiation of renal replacement therapy and therapeutic plasma exchange /plasma transfusions in refractory cases can improve the renal outcome. We present 2 patients with snakebite envenomation who had TMA and were managed with Fresh frozen plasma transfusions, without the need for therapeutic Plasma exchange.