{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:39:32Z","timestamp":1793133572865,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:p> There are 3 species of hump-nosed pit vipers in Sri Lanka: Hypnale hypnale, Hypnale zara, and Hypnale nepa. The latter 2 are endemic to the country. Microangiopathic hemolytic anemia (MAHA) is a known complication of hump-nosed pit viper bites. It was previously documented as a complication of general viper bites and not species specific. We report a series of 3 patients who developed MAHA after being bitten by each species of hump-nosed pit viper. The first patient was bitten by H hypnale and developed a severe form of MAHA associated with acute kidney injury and thrombocytopenia falling into the category of thrombotic microangiopathy. The other 2 developed MAHA that resolved without any complications. <\/jats:p>","DOI":"10.1016\/j.wem.2017.11.003","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T16:27:38Z","timestamp":1517502458000},"page":"94-101","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Microangiopathic Hemolytic Anemia Following Three Different Species of Hump-Nosed Pit Viper (Genus: <i>Hypnale<\/i>) Envenoming in Sri Lanka"],"prefix":"10.1177","volume":"29","author":[{"given":"Rathnayaka Mudiyanselage M.K.","family":"Namal Rathnayaka","sequence":"first","affiliation":[{"name":"Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka (Drs Rathnayaka and Rajapakse)"},{"name":"Intensive Care Unit\/Anaesthesia, Provincial General Hospital, Ratnapura, Sri Lanka (Dr Rathnayaka)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusha Nishanthi","family":"Ranathunga","sequence":"additional","affiliation":[{"name":"Medical Unit, Provincial General Hospital, Ratnapura, Sri Lanka (Dr Ranathunga)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senanayake A.M.","family":"Kularatne","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka (Drs Kularatne and Ranasinghe)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanthe","family":"Rajapakse","sequence":"additional","affiliation":[{"name":"Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka (Drs Rathnayaka and Rajapakse)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirani","family":"Ranasinghe","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka (Drs Kularatne and Ranasinghe)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radha","family":"Jayathunga","sequence":"additional","affiliation":[{"name":"Medical Unit, Provincial General Hospital, Ratnapura, Sri Lanka (Dr Ranathunga)"},{"name":"Haematology Unit, Provincial General Hospital, Ratnapura, Sri Lanka (Dr Jayathunga)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,3,1]]},"reference":[{"key":"bibr1-j.wem.2017.11.003","doi-asserted-by":"publisher","DOI":"10.11646\/zootaxa.2232.1.1"},{"issue":"3","key":"bibr2-j.wem.2017.11.003","first-page":"144","volume":"28","author":"De Silva A.","year":"1983","journal-title":"Ceylon Med J"},{"issue":"3","key":"bibr3-j.wem.2017.11.003","first-page":"733","volume":"36","author":"Kasturiratne A.","year":"2005","journal-title":"Southeast Asian J Trop Med Public Health"},{"issue":"2","key":"bibr4-j.wem.2017.11.003","first-page":"117","volume":"13","author":"De Silva A.","year":"1981","journal-title":"The Snake"},{"key":"bibr5-j.wem.2017.11.003","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050218"},{"key":"bibr6-j.wem.2017.11.003","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2012.10.013"},{"key":"#cr-split#-bibr7-j.wem.2017.11.003.1","unstructured":"Namal Rathnayaka RMMK, Kularatne SAM, Ranathunga PEAN, Rajapakse RPVJ, Ranasinghe JGS. 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