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 CASE REPORT
Year : 2013  |  Volume : 23  |  Issue : 4  |  Page : 294-296

Type IV renal tubular acidosis following resolution of acute kidney injury and disseminated intravascular coagulation due to hump-nosed viper bite


Department of Clinical Medicine, National Hospital, Colombo, Sri Lanka

Correspondence Address:
S Karunarathne
Registrar in General Medicine, National Hospital, Colombo
Sri Lanka
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.114476

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Hump-nosed viper bite can cause acute kidney injury (AKI) and disseminated intravascular coagulation. In some patients, it can cause chronic kidney disease necessitating life-long renal replacement therapy. Lack of effective antivenom makes the management of these patients difficult. A 51-year-old Sri Lankan male was admitted with AKI and disseminated intravascular coagulation following a hump-nosed viper bite. He made a complete recovery with blood product support and hemodialysis. Renal biopsy was performed as his renal recovery was prolonged which revealed patchy tubular atrophy and interstitial inflammation suggestive of subacute interstitial nephritis. Later, he presented with hyperkalemic paralysis and acidosis. A diagnosis of late onset type 4 renal tubular acidosis was made and he responded well to a course of fludrocortisone.






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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07