| CASE REPORT |
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| 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
S Karunarathne, Y Udayakumara, D Govindapala, H Fernando
Department of Clinical Medicine, National Hospital, Colombo, Sri Lanka
Correspondence Address:
S Karunarathne
Registrar in General Medicine, National Hospital, Colombo
Sri Lanka
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0971-4065.114476
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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