Hemolytic Uremic Syndrome- a rare complication of viper envenomation

The triad of acute renal failure, thrombocytopenia and haemolytic anaemia with schistocytes(fragmented erythrocytes) comprise the Haemolytic Uraemic Syndrome (HUS).Its pathogenesis involves an activation/lesion of microvascular endothelial cells, mainly in the renal vasculature, secondary to bacterial toxins, drugs, or autoantibodies. Less frequently, renal microthrombi are due to an acquired or a constitutional deficiency in ADAMTS-13, the protease cleaving VonWilebrand factor H. In adults, several HUS are encountered in the course of chronic nephropathies: nephroangiosclerosis, chronic glomerulonephritis, post irradiation nephropathy, scleroderma, disseminated lupus erythematosus, antiphospholipid syndrome, and toxins. Coagulopathy is the commonest important, systemic clinical syndrome caused by snake envenoming in the world, and venom-induced consumption coagulopathy (VICC) is the most clinically important coagulopathy but rare , because it can be complicated by serious and life-threatening haemorrhage .We report a rare case of a farmer developing HUS after 48 hours following Viper bite.