دورية أكاديمية
Thrombotic microangiopathy in hematotoxic snakebites and its impact on the prognosis: an entity often overlooked.
العنوان: | Thrombotic microangiopathy in hematotoxic snakebites and its impact on the prognosis: an entity often overlooked. |
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المؤلفون: | Mohan G; Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India. drganeshmohan@gmail.com., Guduri PR; Department of Transfusion Medicine, OPD Block, JIPMER Hospital Campus, Puducherry, 605006, India., Shastry S; Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India., Kandasamy D; Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India. |
المصدر: | Journal of thrombosis and thrombolysis [J Thromb Thrombolysis] 2019 Oct; Vol. 48 (3), pp. 475-482. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Kluwer Academic Publishers Country of Publication: Netherlands NLM ID: 9502018 Publication Model: Print Cited Medium: Internet ISSN: 1573-742X (Electronic) Linking ISSN: 09295305 NLM ISO Abbreviation: J Thromb Thrombolysis Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: [Dordrecht ; Norwell, MA] : Kluwer Academic Publishers, c1994- |
مواضيع طبية MeSH: | Snake Bites/*complications , Thrombotic Microangiopathies/*etiology, Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Adult ; Animals ; Blood Transfusion ; Case-Control Studies ; Data Interpretation, Statistical ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Thrombotic Microangiopathies/diagnosis |
مستخلص: | Snakebite associated thrombotic microangiopathy (TMA) is a spectrum of disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury (AKI). We carried out this study to find out the prevalence of TMA in hematotoxic snake envenomation and to analyze its impact on the clinical outcome of patients. Retrospective data were collected from the medical records, hospital and lab information system after institutional ethics committee approval. Hematotoxic snake bite patients were categorized into Group 1 (with TMA) and Group 2 (without TMA). Chi square test, Mann-Whitney 'U' test and Odd's ratio (OR) were used for statistical analysis. Out of 331 snakebite cases admitted, 202 (64.33%) were hematotoxic envenomation with a mean age of 42.26 ± 15.61. Majority were males with a male to female ratio of 2.01:1. Lower limb was the most common site of bite (59.9%). The prevalence of coagulopathy, TMA and AKI observed was 56.4, 18.8 and 37.6% respectively. AKI had a significant risk of undergoing hemodialysis when it was associated with TMA (r = 0.635, OR = 19.3182, P < 0.0001). Higher number of patients in Group 1 received more blood products (r = 0.406, OR = 8.525, P < 0.0001). Prolonged hospital stay (17.25 ± 12.23 vs. 8.86 ± 7.18 days, P < 0.0001) and higher complication rates were (33.33% vs. 11.4%, P < 0.0048) observed in patients with TMA. Snakebite associated TMA has a significant impact on the prognosis and understanding the pathophysiology of this entity will help to formulate guidelines. |
References: | Pharmacol Toxicol. 2002 Sep;91(3):106-10. (PMID: 12427109) Nephrology (Carlton). 2006 Oct;11(5):442-8. (PMID: 17014559) Intern Med J. 2007 Aug;37(8):523-8. (PMID: 17640187) Semin Thromb Hemost. 2010 Jun;36(4):444-51. (PMID: 20614396) Anaesth Intensive Care. 2011 Nov;39(6):1124-7. (PMID: 22165369) Toxicon. 2012 Jul;60(1):61-5. (PMID: 22483846) Nephron Clin Pract. 2012;120(4):c179-84. (PMID: 22890468) Transfus Apher Sci. 2013 Dec;49(3):494-8. (PMID: 23545384) J Thromb Haemost. 2013 Jul;11(7):1310-8. (PMID: 23565941) Indian J Hematol Blood Transfus. 2013 Jun;29(2):116-8. (PMID: 24426353) Ceylon Med J. 2014 Mar;59(1):29-30. (PMID: 24682198) Transfus Med Rev. 2015 Apr;29(2):82-9. (PMID: 25556574) Toxicon. 2015 May;98:89-97. (PMID: 25727382) Kidney Int. 1989 Mar;35(3):891-907. (PMID: 2651763) Indian J Nephrol. 2017 Mar-Apr;27(2):161-164. (PMID: 28356675) Blood. 2017 May 25;129(21):2857-2863. (PMID: 28416509) World J Nephrol. 2017 May 6;6(3):150-161. (PMID: 28540205) Case Rep Nephrol. 2017;2017:1348749. (PMID: 28884034) J Clin Apher. 2019 Aug;34(4):507-509. (PMID: 30779435) Pathology. 1997 Nov;29(4):399-402. (PMID: 9423222) |
فهرسة مساهمة: | Keywords: Hematotoxic snakebite; India; Pathophysiology of snakebite associated TMA; Therapeutic guidelines; Thrombotic microangiopathy |
تواريخ الأحداث: | Date Created: 20190428 Date Completed: 20200219 Latest Revision: 20200225 |
رمز التحديث: | 20240628 |
DOI: | 10.1007/s11239-019-01868-z |
PMID: | 31028512 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1573-742X |
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DOI: | 10.1007/s11239-019-01868-z |