Merchant, M RKhanna, U BAlmeida, A FAcharya, V NMittal, B V1989-07-012009-05-301989-07-012009-05-301989-07-01Merchant MR, Khanna UB, Almeida AF, Acharya VN, Mittal BV. Clinicopathological study of acute renal failure following viperine snake bite. Journal of the Association of Physicians of India. 1989 Jul; 37(7): 430-3http://imsear.searo.who.int/handle/123456789/88648Fifty patients of acute renal failure following Viperine snake bite were studied. Oliguria (100%), local swelling (48%) and bleeding tendencies (42%) were the predominant clinical features encountered. Of the 25 patients in whom detailed coagulation studies were done, 24 patients had disseminated intravascular coagulation (DIC) and 1 had primary fibrinolysis. DIC was commoner with Russell's viper bite (62%) in comparison to Echis carinatus bites (40%). Renal histology obtained in 29 cases revealed tubular necrosis (35%), cortical necrosis (24%) tubular degeneration (17%) and glomerular changes (17%). Ballooning of glomerular capillaries (59%), splitting of glomerular basement membrane (40.7%), swelling of endothelial cells (29.6%), and focal proliferation of mesangial cells (17%) were the significant glomerular changes encountered. 20 (40%) patients succumbed, DIC (50%), irreversible shock (30%) and septicaemia (20%) being the immediate causes of death. Development of oliguria within 24 hours of snake bite and cortical necrosis were associated with higher mortality.engAdultFemaleGlomerular Mesangium --pathologyHumansKidney Failure, Acute --chemically inducedKidney Tubular Necrosis, Acute --chemically inducedMaleViper Venoms --poisoningJournal Article