ArticleJournal of thrombosis and thrombolysis2019
Thrombotic microangiopathy in hematotoxic snakebites and its impact on the prognosis: an entity often overlooked.
Article in Journal of thrombosis and thrombolysis, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Snakebite associated thrombotic microangiopathy: a systematic review of clinical features, outcomes, and evidence for interventions including plasmapheresis.PLoS neglected tropical diseases · 2020Pooled it
- Diagnosing Syndrome-Like Microangiopathic Hemolytic Anemia After Pit Viper Envenomation: Overcoming Laboratory Gaps in a Resource-Limited Setting: A Case Report From Nepal.Clinical case reports · 2026Article
- Clinical challenges, controversies, and regional strategies in snakebite care in India.The Lancet regional health. Southeast Asia · 2025Review
- Snakebite Associated Thrombotic Microangiopathy and Recommendations for Clinical Practice.Toxins · 2022Review
- Schistocyte quantitation, thrombotic microangiopathy and acute kidney injury in Australian snakebite coagulopathy [ASP28].International journal of laboratory hematology · 2021Article
- Thrombotic microangiopathy due to Bothrops erythromelas: a case report in Northeast Brazil.Revista do Instituto de Medicina Tropical de Sao Paulo · 2020Article
- Redefining the role of therapeutic plasma exchange in complications ofAsian journal of transfusion scienceArticle
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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