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Finsterer J. Before Acute Liver Failure is Attributed to High Altitude, Other Causes Must be Ruled Out. Indian J Crit Care Med 2024;28(12):1180.

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Snakebite is a neglected public health problem in tropical countries. Snakebite envenomation-associated acute kidney injury (SBE-AKI) is a major complication accounting for significant morbidity and mortality. The pathogenesis of SBE-AKI may be multifactorial, including prerenal AKI secondary to hemodynamic alterations, intrinsic renal injury, immune-related mechanisms, venom-induced consumptive coagulopathy and capillary leak syndrome.

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Snakebite-associated acute kidney injury (AKI) poses a significant health burden in the South Asia region, resulting in considerable morbidity and mortality. Multiple factors contribute to the pathogenesis of AKI following snakebites, including hypotension, intravascular haemolysis, disseminated intravascular coagulation, rhabdomyolysis, thrombotic microangiopathy (TMA) and direct nephrotoxicity. Clinical features manifest as anuria, oliguria, haematuria, abdominal pain and hypertension.

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Residual hyperglycemia after successful treatment of a patient with severe copper sulfate poisoning.

J Zhejiang Univ Sci B

December 2024

Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.

Article Synopsis
  • Copper sulfate is commonly used in labs, with rare cases of poisoning; only 140 exposures were reported in a year, and five were intentional (Gummin et al., 2023).
  • Severe copper sulfate poisoning can lead to gastrointestinal injury, hemolysis, and muscle damage, but no long-term hyperglycemia has been previously reported.
  • This case study examines the treatment of a patient who ingested a large dose of copper sulfate, resulting in prolonged uncontrolled hyperglycemia and multiple organ dysfunction, stressing the need for careful monitoring and management post-poisoning.
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Statin-induced liver injury has been widely described. However, cases of clinically significant liver injury are rare. We present a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury with concurrent rhabdomyolysis that worsened after rechallenging, which highlighted the need for pharmacovigilance with statins.

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