Hemolytic Uremic Syndrome- An unusual complication of snake envenomation

Snake envenomation is an important and common cause of acute kidney injury (AKI) in India. The incidence of AKI following snake bite in India is 13-32 percent. It accounts for 1,50,000 deaths every year all over the world. AKI can occur following bites from snakes belonging to Elapidae, Viperidae and Colubridae families, due to multiple mechanisms such as hemodynamic disturbances, direct tubular toxicity, coagulopathy, hemoglobinuria and myoglobinuria. Hemolytic Uremic Syndrome (HUS) is an unusual cause of AKI following snake envenomation. We are reporting case series of two patients who developed HUS following snake envenomation and improved after treatment with therapeutic plasma exchange (TPE). HUS complicating snake bite has been reported earlier but those patients were not offered therapeutic plasma exchange.