Chronic kidney failure following lancehead bite envenoming: a clinical report from the Amazon region

 

Manuela B. Pucca1, Michelle V. S. Franco1 , Jilvando M. Medeiros1, Isadora S. Oliveiras2, Shirin Ahmadi3, Felipe A. Cerni2, Umberto Zottich1, Bruna K. Bassoli1, Wuelton M. Monteiro4,5, Andreas H. Laustsen3

 

1 Medical School, Federal University of Roraima, Boa Vista, RR, Brazil.

2 Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.

3 Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark.

4 School of Health Sciences, Amazonas State University, Manaus, AM, Brazil.

5 Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, AM, Brazil.

 

Abstract Background:

Snakebite envenoming can be a life-threatening condition, for which emergency care is essential. The Bothrops (lancehead) genus is responsible for most snakebite-related deaths and permanent loss of function in human victims in Latin America. Bothrops spp. venom is a complex mixture of different proteins that are known to cause local necrosis, coagulopathy, and acute kidney injury. However, the long-term effects of these viper envenomings have remained largely understudied.

 

Case presentation: Here, we present a case report of a 46-years old female patient from Las Claritas, Venezuela, who was envenomed by a snake from the Bothrops genus. The patient was followed for a 10-year period, during which she presented oliguric renal failure, culminating in kidney failure 60 months after the envenoming.

 

Conclusion: In Latin America, especially in Brazil, where there is a high prevalence of Bothrops envenoming, it may be relevant to establish long-term outpatient programs. This would reduce late adverse events, such as chronic kidney disease, and optimize public financial resources by avoiding hemodialysis and consequently kidney transplantation.

 

Keywords: Bothrops Snakebite Long-term effects Chronic kidney disease Renal failure

 

Correspondence: manu.pucca@ufrr.br

 

Received: 29 May 2020; Accepted: 24 November 2020; Published online: 14 December 2020.