The incidence of thrombotic microangiopathy (TMA) following snake bite is reported to be ranging from 3.6 to 15%. We report a 10-year-old boy who developed TMA and due to venom-induced consumptive coagulopathy (VICC) despite receiving adequate and timely doses of snake antivenom following a bite of saw-scaled viper (Echis carinatus sochureki). VICC was managed by plasmapheresis. Though snake bite envenomation-associated renal complications are not uncommon, possibility of TMA should be considered early during management. Our patient developed TMA with subsequent acute cortical necrosis after saw-scaled viper bite despite an adequate and timely dose of snake antivenom which emphasizes the ineffectiveness of antivenom against the venom of given snake species leading to long-term complications.

中文翻译：

---

Echis carinatus sochureki 咬伤后毒液诱发的消耗性凝血病导致血栓性微血管病：抗蛇毒血清有效吗？

据报道，蛇咬伤后血栓性微血管病 (TMA) 的发生率为 3.6% 至 15%。我们报告了一名 10 岁的男孩，尽管在被锯鳞毒蛇 (Echis carinatus sochureki) 咬伤后接受了足够且及时剂量的抗蛇毒血清，但仍患上了 TMA 和毒液诱发的消耗性凝血病 (VICC)。VICC 通过血浆去除术进行管理。尽管蛇咬伤毒液相关的肾脏并发症并不少见，但在治疗过程中应尽早考虑 TMA 的可能性。我们的患者在锯鳞毒蛇咬伤后出现 TMA 并随后出现急性皮质坏死，尽管及时给予了足够剂量的抗蛇毒血清，这强调了抗蛇毒血清对特定蛇类毒液的无效性会导致长期并发症。