Pituitary dysfunction in survivors of Russell's viper snake bite envenomation: A prospective study

摘要: Purpose: Endocrinal insufficiency caused by vasculotoxic snake envenomation is under-recognized and mostly confined to a specific geographic area. We conducted prospective study determine the prevalence pattern of pituitary-target gland insufficiencies envenomation. Materials Methods: The hormonal evaluation patients who had suffered from was done at baseline 6 months follow-up. Those with documented underwent magnetic resonance imaging (MRI) hypothalamo-pituitary severity assessed acute physiology chronic health II (APACHE-II) score, sepsis-related organ failure assessment (SOFA) bite score (SBSS) for all patients. Results: Seventy-six were seen during period, which 60 available repeat months, majority belonging middle age group (mean age, 37.6 ± 14.9 years). mean lag period presentation 32 20 h. Thirty-five (46.1%) coagulopathy, (26.3%) kidney injury (AKI), 8 76 (10.5%) needed renal replacement therapy (RRT) in form hemodialysis. Six (out 41 bites) developed hypopituitarism, continuation hypopituitarism that they developed. Growth hormone glucocorticoid deficiencies most common endocrinopathies observed. occurrence observed only (due Russell's viper); insufficiency, or any scoring tools did not predict hypopituitarism. Conclusion: Acute asymptomatic symptomatic are important sequelae viper small proportion can occur presence normal pituitary imaging. Routine screening should be within first snakebite as dysfunction often these