Viper bites complicate chronic agrochemical nephropathy in rural Sri Lanka

• Published in: Journal of Venomous Animals and Toxins including Tropical Diseases
• Main Authors: Anjana Silva, Rivikelum Samarasinghe, Senaka Pilapitiya, Niroshana Dahanayake, Sisira Siribaddana
• Format: Article in Journal/Newspaper
• Language: English
• Published: SciELO 2014
• Subjects: Snakebite; Chronic kidney disease; Agricultural nephropathy; Epidemiology; Anuria; Arctic medicine. Tropical medicine; RC955-962; Toxicology. Poisons; RA1190-1270; Zoology; QL1-991; Arctic
• Online Access: https://doi.org/10.1186/1678-9199-20-33; https://doaj.org/article/c6939e1eaa8f4eca85c97759e8aea190

Snakebite is a common occupational health hazard among Sri Lankan agricultural workers, particularly in the North Central Province. Viperine snakes, mainly Russell’s viper envenomation, frequently lead to acute renal failure. During the last two decades, an agrochemical nephropathy, a chronic tubulointerstitial disease has rapidly spread over this area leading to high morbidity and mortality. Most of the epidemiological characteristics of these two conditions overlap, increasing the chances of co-occurrence. Herein, we describe four representative cases of viperine snakebites leading to variable clinical presentations, in patients with chronic agrochemical nephropathy, including two patients presented with acute and delayed anuria. These cases suggest the possibility of unusual manifestations of snakebite in patients with Sri Lankan agrochemical nephropathy, of which the clinicians should be aware. It could be postulated that the existing scenario in the Central America could also lead to similar clinical presentations.