Display options
Cite
Udayabhaskaran V, Arun Thomas ET, Shaji B. Capillary Leak Syndrome Following Snakebite Envenomation. Indian J Crit Care Med. 2017;21(10):698-702doi: 10.4103/ijccm.IJCCM_41_17.
Udayabhaskaran, V., Arun Thomas, E. T., & Shaji, B. (2017). Capillary Leak Syndrome Following Snakebite Envenomation. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 21(10), 698-702. https://doi.org/10.4103/ijccm.IJCCM_41_17
Udayabhaskaran, V, et al. "Capillary Leak Syndrome Following Snakebite Envenomation." Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine vol. 21,10 (2017): 698-702. doi: https://doi.org/10.4103/ijccm.IJCCM_41_17
Udayabhaskaran V, Arun Thomas ET, Shaji B. Capillary Leak Syndrome Following Snakebite Envenomation. Indian J Crit Care Med. 2017 Oct;21(10):698-702. doi: 10.4103/ijccm.IJCCM_41_17. PMID: 29142382; PMCID: PMC5672676.
Copy Download .nbib Format: NLM
Share it on

Indian J Crit Care Med. 2017 Oct;21(10):698-702. doi: 10.4103/ijccm.IJCCM_41_17.

Capillary Leak Syndrome Following Snakebite Envenomation.

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

V Udayabhaskaran, E T Arun Thomas, Bhagya Shaji

Affiliations

  1. Department of Internal Medicine, Malabar Medical College, Kozhikode, Kerala, India.
  2. Department of Nephrology, Government Medical College, Thiruvananthapuram, Kerala, India.
  3. Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India.

PMID: 29142382 PMCID: PMC5672676 DOI: 10.4103/ijccm.IJCCM_41_17

Abstract

Capillary leak syndrome is a unique complication that follows Russell's viper envenomation. This syndrome has a very high fatality rate and is characterized by parotid swelling, chemosis, periorbital edema, hypotension, albuminuria, hypoalbuminemia, and hemoconcentration. This syndrome is frequently recognized from the southern parts of India, especially from the state of Kerala. It has been postulated that a vascular apoptosis inducing component of Russell's viper venom that is not neutralized by the commercially available anti-snake venom (ASV) is responsible for this complication as it occurs even after adequate doses of ASV administration in most cases. Acute kidney injury often requiring dialysis is invariably present in all patients because of reduced renal perfusion and ischemic acute tubular necrosis as a result of hypotension. Management mainly involves aggressive fluid resuscitation to maintain adequate tissue perfusion. There are no other proven effective treatment modalities, except a few reports of successful treatment with plasmapheresis. Methylprednisolone pulse therapy, terbutaline, aminophylline, and intravenous immunoglobulin are other treatment modalities tried.

Keywords: Capillary leak syndrome; Russell's viper; Snakebite; envenomation

Conflict of interest statement

There are no conflicts of interest.

References

  1. Crit Care Med. 2008 Jan;36(1):296-327 - PubMed
  2. Lancet. 1984 Oct 6;2(8406):765-8 - PubMed
  3. Toxicon. 2005 Dec 1;46(7):806-13 - PubMed
  4. N Engl J Med. 2010 Mar 4;362(9):779-89 - PubMed
  5. Am J Cardiol. 2000 Feb 15;85(4):518-20, A11 - PubMed
  6. Toxicon. 2000 Sep;38(9):1253-66 - PubMed
  7. Biochimie. 2010 Dec;92(12):1854-66 - PubMed
  8. Emerg Med J. 2008 Apr;25(4):200-4 - PubMed
  9. Toxicon. 2007 Apr;49(5):615-24 - PubMed
  10. Nephrol Dial Transplant. 1996;11 Suppl 2:24-7 - PubMed
  11. N Engl J Med. 2008 Jan 10;358(2):125-39 - PubMed
  12. N Engl J Med. 2014 May 1;370(18):1683-93 - PubMed
  13. Medicine (Baltimore). 1977 May;56(3):225-39 - PubMed
  14. Crit Care. 2007;11 Suppl 2:S1-201 - PubMed
  15. J Clin Diagn Res. 2014 Oct;8(10):VC01-VC03 - PubMed
  16. Biochem Biophys Res Commun. 1996 Jul 5;224(1):134-9 - PubMed
  17. Transfus Apher Sci. 2013 Dec;49(3):494-8 - PubMed
  18. Ann Intern Med. 1999 Jun 1;130(11):905-9 - PubMed
  19. Toxicon. 2005 Mar 1;45(3):335-46 - PubMed
  20. N Engl J Med. 2014 Oct 16;371(16):1496-506 - PubMed
  21. Eur J Biochem. 1998 Apr 1;253(1):36-41 - PubMed
  22. Biochemistry. 2000 Mar 28;39(12):3197-205 - PubMed
  23. N Engl J Med. 2001 Nov 8;345(19):1368-77 - PubMed
  24. Am J Med. 1997 Dec;103(6):514-9 - PubMed
  25. J Assoc Physicians India. 2005 Jan;53:46-8 - PubMed
  26. Clin J Am Soc Nephrol. 2006 Jul;1(4):749-53 - PubMed
  27. PLoS Med. 2008 Nov 4;5(11):e218 - PubMed
  28. N Engl J Med. 2012 Jul 12;367(2):124-34 - PubMed
  29. Crit Care Med. 2013 Feb;41(2):580-637 - PubMed
  30. Toxicon. 2003 Dec 15;42(8):827-40 - PubMed

Publication Types