Review of Pathophysiology of Russell’s Viper Envenomation and Clinical Utility of Serum Lactate Dehydrogenase as a Predictor of Severity and Outcome

Author: Aung Ye Kyaw ; Shyh Poh Teo
Publication Type:Journal Article
Keywords: envenomation; haemolysis; lactate dehydrogenase; snake bites; viperidae
From: Pacific Journal of Medical Sciences 2025;26(2):41-48
CountryPapua New Guinea
Language:English
Abstract: Russell’s viper (Daboia russelii) envenomation is a major public health problem in South and Southeast Asia, often resulting in life-threatening complications such as acute kidney injury (AKI), disseminated intravascular coagulation (DIC), and shock. Serum lactate dehydrogenase (LDH), an accessible and cost- effective biochemical marker, has been proposed as a surrogate indicator of tissue injury, haemolysis, and severity of systemic envenomation. This review explores the role of LDH in the context of Russell's viper bite, examining the pathophysiological basis of envenomation and its complications, the mechanism of LDH elevation, and clinical studies correlating LDH levels with severity and outcomes. The findings suggest that elevated LDH may assist in early recognition of severe envenomation, guide timely interventions, and serve as a valuable adjunct to clinical and laboratory assessment in resource-limited settings.