Confirmation of Snakebite through Renal Changes Observed at Autopsy Utilizing Mukhopadhyay’s Score

Snakebite envenomation represents a signi^icant global health concern with approximately 81,000-138,000 annual deaths worldwide, disproportionately affecting South Asia and sub-Saharan Africa. Postmortem diagnosis of snakebite remains challenging when clinical history is ambiguous, or bite marks are absent. Venom-induced acute kidney injury produces characteristic histopathological changes that persist after death. The Mukhopadhyay’s scoring system evaluates specific renal histopathological findings to provide an objective framework for postmortem snakebite diagnosis, particularly valuable in resource-limited settings where advanced diagnostic techniques are inaccessible.

To determine the renal changes at autopsy in snake bite victims using the diagnostic criteria Mukhopadhyay’s Score (MS).

This observational cross-sectional study was conducted at Government Villupuram Medical College (Tamil Nadu) from January 2022 to December 2024. 82 cases were examined after obtaining informed consent from their families. Sociodemographic data and samples for gross and histopathological examination were collected. Renal findings were scored using Mukhopadhyay’s criteria based on lesion type, distribution, and severity. Statistical analysis examined associations between demographic characteristics, MS scores, and DF distribution.

The study population had a mean age of 45 years, with most of the victims aged >50 years. Haemotoxic envenomation accounted for 58.54% of fatalities. Chi-square analysis revealed signi^icant associations between age >50 years and both MS Score (p=0.012) and envenomation type (p=0.003). Gross examination of both the kidney showed hemorrhage in medulla, while histopathology picture demonstrated progression of renal damage from minimal congestion to diffuse tubular necrosis corresponding with increasing MS scores (0 to 2).

This study confirms the utilization of Mukhopadhyay’s score as an effective tool for postmortem snakebite diagnosis through characteristic renal histopathological changes. The significant association between higher age and renal damage severity provides important forensic and clinical insights. The progressive relationship between MS scores and renal pathology offers reliable diagnostic criteria applicable in resource-constrained settings such as our country.