Haematological changes after snake bite: a clinico-haematological study in a teaching hospital of South Bengal, India

Background: Snake bite can result in local as well as systemic manifestations. Major systemic complications include acute renal failure, neurological symptoms requiring ventilator support and coagulation disorders. The coagulation disorders lead to various serious systemic complications like haemorrhage, infarction and even death if the diagnosis and treatment are delayed.

Objectives: To describe the clinical profile of the snake bitten patients who developed coagulopathy and the role of coagulation markers to evaluate the morbidity and mortality of the victims.

Method: A cross-sectional hospital based study was done on patients aged 12 years or less having local or systemic signs of envenomation and no history of bleeding or coagulation disorders. The coagulation profile was assessed by peripheral blood sampling and urine analysis.

Results: In the present study haemorrhagic manifestations seen included bleeding from injection site (46.7%), haematemesis (5%), haematuria (33.3%), bleeding gums (11.7%), epistaxis (1.7%), and haemoptysis (3.3%). Haemoglobin estimation revealed anaemia in 53.3% cases. The 20 minute whole blood clotting time (WBCT20) was positive in 86.4% of vasculo-toxic snakebites and negative in all neuro-paralytic bites. Leucocytosis was observed in 60% cases with relative neutrophilia in 63.3%, thrombocytopenia was observed in 8.3%, bleeding time was prolonged in 13.3% and clotting time was prolonged in 56.7%.

Conclusions: WBCT 20 is an important test to differentiate between viperine and elapine bites as it was positive in 46.7% of viperine bites and was negative in all elapine bites

Sri Lanka Journal of Child Health, 2021; 50: 12-16